Dominguez Castro Patricia, Reynolds Ciara, Bizzaro Maria Gabriella, Kennelly Sharon, Clyne Barbara, Bury Gerard, Bradley Catriona, Finnigan Karen, McCullagh Laura, Murrin Celine, Perrotta Carla, Gibney Eileen R, Corish Clare A
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland.
UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
BJGP Open. 2021 Apr 26;5(2). doi: 10.3399/BJGPO.2020.0131. Print 2021 Apr.
Oral nutritional supplements (ONS) are recommended for patients who are malnourished or at risk of malnutrition. Appropriate ONS prescribing requires regular monitoring to assess its continued requirement. Previous research identified long-term ONS prescriptions (>6 months) without review, with 70% of these influenced by social factors.
To investigate the characteristics of long-term ONS users in Ireland and the determinants of larger volumes of ONS dispensing.
DESIGN & SETTING: Secondary analysis of anonymous dispensed pharmacy claims data of patients dispensed standard ONS for 12 consecutive months in 2018 ( = 912).
Factors showing significant (<0.05) univariate associations with above the median consumption of ONS units were entered into a multivariable model.
Median age was 76 (range 18 to 101) years, with 66.9% of the sample being ≥65 years. Almost 70% of the samples were on polypharmacy (45.6%; ≥5 medications) or excessive polypharmacy (21.5%; ≥10 medications). Younger age and being on polypharmacy for drugs having an effect on the central nervous system (CNS) were significantly associated with being dispensed more ONS units in univariate and multivariate analysis. Those patients in the age range 18 to 44 were 2.5 fold more likely to be prescribed more ONS units (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5 to 4.3; <0.001). Patients using CNS drugs or on CNS polypharmacy were more likely to be prescribed more ONS units (ORs 1.2 and 2.4; 95% CI 0.9 to 1.4 and 1.3 to 4.4 respectively; = 0.029) CONCLUSION: Older age and polypharmacy characterise long-term ONS users in this study. Younger age and CNS medication polypharmacy are predictors of more ONS units prescribed over a year
对于营养不良或有营养不良风险的患者，推荐使用口服营养补充剂（ONS）。合理开具ONS处方需要定期监测以评估持续需求。先前的研究发现存在未经复查的长期ONS处方（>6个月），其中70%受社会因素影响。
调查爱尔兰长期使用ONS者的特征以及ONS配给量较大的决定因素。
对2018年连续12个月配发标准ONS的患者的匿名药房配药索赔数据进行二次分析（n = 912）。
将与ONS单位消耗量高于中位数呈显著（P<0.05）单变量关联的因素纳入多变量模型。
中位年龄为76岁（范围18至101岁），样本中66.9%的人年龄≥65岁。近70%的样本使用多种药物（45.6%；≥5种药物）或过度使用多种药物（21.5%；≥10种药物）。在单变量和多变量分析中，年龄较小以及使用对中枢神经系统（CNS）有影响的药物而使用多种药物与配发更多ONS单位显著相关。年龄在18至44岁之间的患者被开具更多ONS单位处方的可能性高2.5倍（比值比[OR] 2.5；95%置信区间[CI] 1.5至4.3；P<0.001）。使用CNS药物或使用CNS多种药物的患者更有可能被开具更多ONS单位处方（OR分别为1.2和2.4；95% CI分别为0.9至1.4和1.3至4.4；P = 0.029）。结论：在本研究中，年龄较大和使用多种药物是长期ONS使用者的特征。年龄较小和CNS药物多种用药是一年中开具更多ONS单位处方的预测因素。
