University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Aging Clin Exp Res. 2021 Jul;33(7):1919-1928. doi: 10.1007/s40520-020-01693-y. Epub 2020 Sep 9.
Older people use many medications, but combinations of medications used among the oldest old (≥ 80 years) are not commonly reported.
This study aimed to determine common combinations of medications used among women aged 77-96 years and to describe characteristics associated with these combinations.
A cohort study of older women enroled in the Australian Longitudinal Study on Women's Health over a 15-year period was used to determine combinations of medications using latent class analysis. Multinomial logistic regression was used to determine characteristics associated with these combinations.
The highest medication users during the study were for the cardiovascular (2003: 80.28%; 2017: 85.63%) and nervous (2003: 66.03%; 2017: 75.41%) systems. A 3-class latent model described medication use combinations: class 1: 'Cardiovascular & neurology anatomical group' (27.25%) included participants using medications of the cardiovascular and nervous systems in their later years; class 2: 'Multiple anatomical group' (16.49%) and class 3: 'Antiinfectives & multiple anatomical group' (56.27%). When compared to the reference class (class 1), the risk of participants being in class 3 was slightly higher than being in class 2 if they had > 4 general practitioner visits (RRR 2.37; 95% CI 2.08, 2.71), Department of Veterans Affairs' coverage (RRR 1.59; 95% CI 1.36, 1.86), ≥ 4 chronic diseases (RRR 3.16; 95% CI 2.56, 3.90) and were frail (RRR 1.47; 95% CI 1.27, 1.69).
Identification of combinations of medication use may provide opportunities to develop multimorbidity guidelines and target medication reviews, and may help reduce medication load for older individuals.
老年人使用多种药物，但针对 80 岁以上老年人的常用药物组合并未得到广泛报道。
本研究旨在确定 77-96 岁女性中常用药物组合，并描述与这些组合相关的特征。
本研究采用澳大利亚女性健康纵向研究的队列研究，在 15 年的时间里使用潜在类别分析确定药物组合。使用多项逻辑回归确定与这些组合相关的特征。
在研究期间，使用最多的药物是心血管系统（2003 年：80.28%；2017 年：85.63%）和神经系统（2003 年：66.03%；2017 年：75.41%）药物。一个 3 类潜在模型描述了药物使用组合：第 1 类：“心血管和神经解剖学组”（27.25%），包括在晚年使用心血管和神经系统药物的参与者；第 2 类：“多个解剖学组”（16.49%）和第 3 类：“抗感染药物和多个解剖学组”（56.27%）。与参考组（第 1 类）相比，如果参与者有>4 次全科医生就诊（RRR 2.37；95%CI 2.08,2.71）、有退伍军人事务部的保险（RRR 1.59；95%CI 1.36,1.86）、有≥4 种慢性疾病（RRR 3.16；95%CI 2.56,3.90）或体弱（RRR 1.47；95%CI 1.27,1.69），则其处于第 3 类的风险略高于第 2 类。
确定药物使用组合可能为制定多病共存指南和药物审查提供机会，并可能有助于减少老年人的药物负担。
