Giraffe Pharmacy, Tainan City 710, Taiwan.
Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan City 717, Taiwan.
Int J Environ Res Public Health. 2021 Jan 22;18(3):985. doi: 10.3390/ijerph18030985.
Aging is accompanied by changes in organ degeneration, and susceptibility to multiple diseases, leading to the frequent occurrence of adverse drug reactions resulting from polypharmacy (PP) and potentially inappropriate medications (PIM) in older patients. This study employs a retrospective cohort design and investigates the association of PP with PIM among older patients with high rates of medical utilization. Using records from a national pharmaceutical care database, an experimental group is formed from patients meeting these criteria, who are then offered home pharmaceutical care. Correspondingly, a control group is formed by identifying older patients with regular levels of use of medical services who had been dispensed medications at community pharmacies. Multivariate logistic regression is performed to assess the association between the rate of PIM and variables, including age, gender, and PP. The study finds that experimental PP participants had a higher rate of PIM prescription (odds ratio (OR) = 5.4) than non-PP control participants (all < 0.001). In clinical practice, additional caution is required to avoid PIMs. Patients engaged in continuously using long-term medication should take precautions in daily life to alleviate related discomforts. Pharmacists should serve as a bridge between patients and physicians to enhance their health and improve their quality of life.
衰老是伴随着器官退化和多种疾病易感性的变化而发生的,这导致了老年患者中由于多药治疗(PP)和潜在不适当药物(PIM)而频繁发生药物不良反应。本研究采用回顾性队列设计,调查了高医疗利用率老年患者中 PP 与 PIM 之间的关联。使用国家药物治疗数据库的记录,从符合这些标准的患者中组成实验组,然后为他们提供家庭药物治疗。相应地,通过确定在社区药房配药的具有常规医疗服务使用水平的老年患者,来组成对照组。采用多变量逻辑回归来评估 PIM 发生率与包括年龄、性别和 PP 在内的变量之间的关联。研究发现,实验组的 PP 患者的 PIM 处方率(比值比(OR)=5.4)高于非-PP 对照组患者(均<0.001)。在临床实践中,需要格外小心以避免 PIM。持续使用长期药物的患者应在日常生活中采取预防措施,以减轻相关不适。药剂师应充当患者和医生之间的桥梁,以增进他们的健康并提高他们的生活质量。