University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.
University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia; Priority Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, New Lambton Heights, New South Wales 2305, Australia.
Maturitas. 2021 Apr;146:18-25. doi: 10.1016/j.maturitas.2021.01.005. Epub 2021 Jan 28.
This study aimed to determine the prevalence of continuous polypharmacy and hyperpolypharmacy, determine medications that contribute to continuous polypharmacy, and examine the association between frailty and continuous polypharmacy.
A prospective study using data from the Australian Longitudinal Study on Women's Health. Women aged 77-82 years in 2003, and 91-96 years in 2017 were analysed, linking the Pharmaceutical Benefits Scheme data to participants' survey data.
The association between frailty and continuous polypharmacy was determined using generalised estimating equations for log binomial regressions, controlling for confounding variables. Descriptive statistics were used to determine the proportion of women with polypharmacy, and medications that contributed to polypharmacy.
The proportion of women with continuous polypharmacy increased over time as they aged. Among participants who were frail (n = 833) in 2017, 35.9 % had continuous polypharmacy and 1.32 % had hyperpolypharmacy. Among those who were non-frail (n = 1966), 28.2 % had continuous polypharmacy, and 1.42 % had hyperpolypharmacy. Analgesics (e.g. paracetamol) and cardiovascular medications (e.g. furosemide and statins) commonly contributed to continuous polypharmacy among frail and non-frail women. Accounting for time and other characteristics, frail women had an 8% increased risk of continuous polypharmacy (RR 1.08; 95 % CI 1.05, 1.11) compared to non-frail women.
Combined, polypharmacy and frailty are key clinical and public health challenges. Given that one-third of women had continuous polypharmacy, monitoring and review of medication use among older women are important, and particularly among women who are frail.
本研究旨在确定连续多药治疗和超连续多药治疗的流行率，确定导致连续多药治疗的药物，并研究衰弱与连续多药治疗之间的关系。
这是一项使用澳大利亚妇女健康纵向研究数据的前瞻性研究。对 2003 年年龄为 77-82 岁的女性和 2017 年年龄为 91-96 岁的女性进行了分析，将药品福利计划数据与参与者的调查数据相链接。
使用广义估计方程对数二项式回归来确定衰弱与连续多药治疗之间的关系，同时控制混杂变量。使用描述性统计来确定多药治疗的女性比例和导致多药治疗的药物。
随着年龄的增长，连续多药治疗的女性比例呈上升趋势。在 2017 年衰弱的参与者中（n=833），35.9%的人有连续多药治疗，1.32%的人有超连续多药治疗。在非衰弱的参与者中（n=1966），28.2%的人有连续多药治疗，1.42%的人有超连续多药治疗。在衰弱和非衰弱的女性中，镇痛药（如对乙酰氨基酚）和心血管药物（如呋塞米和他汀类药物）通常会导致连续多药治疗。考虑到时间和其他特征，与非衰弱的女性相比，衰弱的女性连续多药治疗的风险增加了 8%（RR 1.08；95%CI 1.05，1.11）。
综合来看，多药治疗和衰弱是重要的临床和公共卫生挑战。鉴于三分之一的女性有连续多药治疗，监测和审查老年女性的药物使用情况非常重要，尤其是那些衰弱的女性。
