探究中国社区慢性病老年患者的多重用药负担：一项横断面研究。
Exploring polypharmacy burden among elderly patients with chronic diseases in Chinese community: a cross-sectional study.
机构信息
School of Nursing and Health, Zhengzhou University, No.100 Science Avenue, Henan, Zhengzhou, China.
Peking University People's Hospital, Xicheng Dist, Beijing, China.
出版信息
BMC Geriatr. 2021 May 13;21(1):308. doi: 10.1186/s12877-021-02247-1.
BACKGROUND
In the long-term use of multiple medications for elderly patients diagnosed with chronic diseases, medication problems are prominent, which seriously reduces their quality of life. The burden of medications of patients critically affects their medication beliefs, behaviors and disease outcomes. It may be a solution to stress the burden of medications of patients. Its medication issues develops a novel perspective. The present study aimed to exploit the Chinese version of Living with Medicines Questionnaire-3(C-LMQ-3) to quantify the medicines burden of elderly patients diagnosed with chronic diseases in China, and evaluate the relevant demographic characteristics of sub-populations with high medicines burden.
METHODS
The survey was distributed to elderly patients aged ≥ 60 years with chronic disease by using ≥ 5 medicines, C-LMQ-3 scores and domain scores were compared by the characteristics of elderly patients by employing descriptive statistics and performing statistical tests.
RESULTS
On the whole, 430 responses were analyzed, and the participants were aged between 60 and 91 years, with the average age of 73.57 years (SD: 7.87). Most of the responses were female (61.7 %) with middle school education (38.5 %). Moreover, 54.1 % of the participants lived with spouse only, 16.2 % had both spouse and children, and 10.0 % lived alone. As indicated from regression analysis, higher C-LMQ-3 scores were associated with those who were with low education level, 60-69 years-old, using ≥ 11 medicines, using medicines ≥ 3 times a day, income per month (RMB) ≤ 3000, and who having higher monthly self-paid medication (RMB) ≥ 300 (p < 0.01). Burden was mainly driven by cost-related burden, concerns about medicines, and the lack of autonomy over medicine regimens.
CONCLUSIONS
This study presents the preliminary evidence to elderly patients diagnosed with chronic diseases in mainland China that pay attention to multiple medications burden may help reduce the Drug Related Problems, whereas some elderly patients have a higher burden of medication. Chinese health care providers are required to primarily evaluate and highlight such patients, and formulate relevant intervention strategies to ensure medication adherence and daily medication management of elderly patients with polypharmacy.
背景
在长期使用多种药物治疗患有慢性病的老年患者中，药物问题突出，严重降低了他们的生活质量。患者的药物负担严重影响了他们的用药信念、行为和疾病结局。强调患者的药物负担可能是解决问题的一种方法，这为药物问题的研究提供了一个新视角。本研究旨在开发中文版的《用药生活问卷-3（C-LMQ-3）》，以量化中国患有慢性病的老年患者的药物负担，并评估具有高药物负担的亚人群的相关人口统计学特征。
方法
通过使用≥5 种药物对年龄≥60 岁的患有慢性病的老年患者进行调查，采用描述性统计和统计学检验比较了老年患者的特征与 C-LMQ-3 评分和各领域评分的关系。
结果
共分析了 430 份答卷，参与者年龄在 60 至 91 岁之间，平均年龄为 73.57 岁（标准差：7.87）。大多数答卷者为女性（61.7%），具有中学教育程度（38.5%）。此外，54.1%的参与者与配偶同住，16.2%的参与者与配偶和子女同住，10.0%的参与者独居。回归分析表明，C-LMQ-3 评分较高与受教育程度较低、年龄在 60-69 岁、使用≥11 种药物、每天使用药物≥3 次、月收入（人民币）≤3000 元以及每月自付药物费用（人民币）≥300 元的患者有关（p<0.01）。负担主要由与成本相关的负担、对药物的担忧以及对药物治疗方案缺乏自主权驱动。
结论
本研究为中国大陆患有慢性病的老年患者提供了初步证据，即关注多重药物负担可能有助于减少药物相关问题，而一些老年患者的药物负担更高。中国的医疗保健提供者需要首先评估和关注这些患者，并制定相关的干预策略，以确保服用多种药物的老年患者的药物依从性和日常药物管理。
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