Nind James, Smith Alesha, Devananda Manjula, Auvray Benoit
School of Pharmacy, University of Otago Dunedin New Zealand.
Airmed Ltd Dunedin New Zealand.
Health Sci Rep. 2021 Mar 10;4(2):e263. doi: 10.1002/hsr2.263. eCollection 2021 Jun.
Polypharmacy (≥5 medicines) and hyperpolypharmacy (≥10 medicines) can significantly impact people's health. The literature surrounding polypharmacy focuses on the elderly, particularly rest home populations, with few studies looking into younger age bands. Moreover, there have been no recent studies looking into the rates of polypharmacy in New Zealand. This study aimed to determine whether polypharmacy rates have increased over time in the New Zealand population. Specifically investigating polypharmacy rates across age and ethnicity, and identifying which medicines are most commonly prescribed in people with polypharmacy.
A nationwide retrospective observational study was carried out between 2014 and 2018 on 4 697 274 New Zealanders (96% of the population) by linking dispensing data from the Pharmaceutical Collection to patient enrolment data using a National Health Identifier (NHI) to identify the rate of long-term medicine prescribing in New Zealand.
Our study found the rate of polypharmacy to be 9.93% and hyperpolypharmacy to be 1.92% nationwide in 2018, a percentage increase of 4.1% and 7.11% from 2014, respectively. During the same period, we observed the greatest percentage increase (30.37%) in the rate of polypharmacy in the 20 to 29 age band while the rates decreased in older populations. Variation was also noted between ethnicities. Medicines contributing to polypharmacy differed by age group.
Current methods for minimizing polypharmacy and optimizing medicines use are narrowly focused on the elderly. Despite an increase in education and awareness raising campaigns, rates continue to rise in New Zealand's population.
多重用药(≥5种药物)和超多重用药(≥10种药物)会对人们的健康产生重大影响。关于多重用药的文献主要聚焦于老年人,尤其是养老院人群,针对较年轻年龄段的研究较少。此外,近期没有关于新西兰多重用药率的研究。本研究旨在确定新西兰人群中多重用药率是否随时间增加。具体调查不同年龄和种族的多重用药率,并确定多重用药人群中最常开具的药物。
2014年至2018年间,通过使用国家健康标识符(NHI)将药品收集的配药数据与患者登记数据相链接,对4697274名新西兰人(占总人口的96%)进行了一项全国性回顾性观察研究,以确定新西兰长期药物处方率。
我们的研究发现,2018年全国多重用药率为9.93%,超多重用药率为1.92%,分别比2014年增加了4.1%和7.11%。在同一时期,我们观察到20至29岁年龄组的多重用药率增长百分比最大(30.37%),而老年人群的多重用药率有所下降。不同种族之间也存在差异。导致多重用药的药物因年龄组而异。
目前将多重用药降至最低并优化药物使用的方法主要集中在老年人身上。尽管开展了更多教育和提高认识的活动,但新西兰人群中的多重用药率仍在上升。