Chang Chee-Tao, Ang Ju-Ying, Islam Md Asiful, Chan Huan-Keat, Cheah Wee-Kooi, Gan Siew Hua
Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh 30400, Perak, Malaysia.
Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Pharmaceuticals (Basel). 2021 Feb 25;14(3):187. doi: 10.3390/ph14030187.
Drug-related problems (DRPs) in the elderly include polypharmacy, potentially inappropriate medications, nonadherence, and drug-related falls. In this systematic review and meta-analysis, the prevalence of DRPs and complementary and alternative medicine (CAM) use among the Malaysian elderly was estimated. PubMed, Scopus, Web of Science, and Google Scholar databases were searched to identify studies published since their inception up to 24 August 2020. A random-effects model was used to generate the pooled prevalence of DRPs along with its corresponding 95% confidence interval (CI). The heterogeneity of the results was estimated using the statistics, and Cochran's Q test and sensitivity analyses were performed to confirm the robustness of the results. We identified 526 studies, 23 of which were included in the meta-analysis. ( = 29,342). The pooled prevalence of DRPs among Malaysian elderly was as follows: (1) polypharmacy: 49.5% [95% CI: 20.5-78.6], (2) potentially inappropriate medications: 28.9% [95% CI: 25.4-32.3], (3) nonadherence to medications: 60.6% [95% CI: 50.2-70.9], and (4) medication-related falls 39.3% [95% CI: 0.0-80.8]. Approximately one in two Malaysian elderly used CAM. The prevalence of polypharmacy and potentially inappropriate medications among the Malaysian elderly population was high, calling for measures and evidence-based guidelines to ensure the safe medication use.
老年人的药物相关问题（DRPs）包括多重用药、潜在不适当用药、用药依从性差以及药物相关跌倒。在这项系统评价和荟萃分析中，估计了马来西亚老年人中DRPs的患病率以及补充和替代医学（CAM）的使用情况。检索了PubMed、Scopus、Web of Science和谷歌学术数据库，以识别自数据库建立至2020年8月24日发表的研究。采用随机效应模型生成DRPs的合并患病率及其相应的95%置信区间（CI）。使用 统计量估计结果的异质性，并进行Cochran's Q检验和敏感性分析以确认结果的稳健性。我们识别出526项研究，其中23项纳入了荟萃分析（n = 29,342）。马来西亚老年人中DRPs的合并患病率如下：（1）多重用药：49.5% [95% CI：20.5 - 78.6]，（2）潜在不适当用药：28.9% [95% CI：25.4 - 32.3]，（3）用药依从性差：60.6% [95% CI：50.2 - 70.9]，以及（4）药物相关跌倒：39.3% [95% CI：0.0 - 80.8]。大约每两名马来西亚老年人中就有一人使用CAM。马来西亚老年人群中多重用药和潜在不适当用药的患病率较高，需要采取措施并制定循证指南以确保安全用药。
