Najjar Anas, Warasna Beesan, Kitaneh Islam, Abu-Sharar Salam, Sawalha Maryam, Jamous Abrar, Qiq Muhannad, Amro Wafa, Makharzeh Enas, Amro Yazan, Subb Laban Bayan, Amro Ahmad
Faculty of Pharmacy, Al-Quds University, Jerusalem, occupied Palestinian territory.
Faculty of Medicine, Al-Quds University, Jerusalem, occupied Palestinian territory.
Lancet. 2021 Jul;398 Suppl 1:S40. doi: 10.1016/S0140-6736(21)01526-9.
Older people (aged 60 years and older) are more susceptible than younger people to multiple medical disorders and are therefore more frequently exposed to polypharmacy. We investigated prevalence of chronic diseases and medical conditions, medications used, and associated sociodemographic factors among older adults of the Palestinian population.
A cross-sectional study was done between June, 2013, and January, 2014. The study population was Palestinians aged 60 years and older living in the West Bank and East Jerusalem. Study participants were selected in a stratified random manner. The sample was selected from all governorates (strata) according to the size of the population of each governate on the basis of census data from the Palestinian Central Bureau of Statistics. The research team visited and interviewed older residents in their houses. Questionnaire items were explained in informal language to participants by the interviewer, to ensure complete understanding, and answers were recorded by the interviewer. Informed written consent was obtained from each participant. The study design and protocols were revised and approved by the Research Ethics Committee at Al-Quds University.
1574 older Palestinian adults were invited to participate, of whom 1192 (76%) enlisted. The mean age was 70·3 years (SD 8·58, range 60-110 years). 55% (659 of 1192) were female and 45% (533) were male. The majority (84%; 996) were non-workers or retired; monthly income for 78% of participants (930) was less than 2500 NIS, which falls in the low-income group. More participants (78%; 934) had governmental health insurance than had private insurance (8%; 89) or no insurance (14%; 169). 40 chronic diseases and conditions were reported. The mean number of diseases reported per participant was 2·33 (SD 1·68, range 0-11). Cardiovascular, endocrine, and musculoskeletal conditions were the most frequently reported. 66% of participants (787 of 1192) reported at least one cardiovascular condition, 40% (480) at least one endocrine condition, and 32% (385) at least one musculoskeletal condition. The most prevalent cardiovascular condition was hypertension, which affected 54% of participants (647); the most prevalent endocrine condition was diabetes (38·2%, 455); and the most prevalent musculoskeletal condition was arthritis (13·7%, 163). The total number of different types of medication (both prescribed and over-the-counter drugs) was 175. The mean number of medications per participant was 4·54 (SD 2·83), and the highest number of different medications being taken by one participant was 17. Commonly prescribed therapeutic agents were aspirin (prescribed to 48% of participants, 575 of 1192), angiotensin-converting-enzyme inhibitors (34%, 403), diuretics (34%, 409), metformin (27%, 323), paracetamol (23%, 270), and protein pump inhibitors (23%, 275).
The findings provide insights into the most prevalent chronic diseases and conditions, as well as the most commonly used medications among older Palestinians. Cardiovascular, endocrine, and musculoskeletal conditions were the most prevalent diseases. Older Palestinians adults are subjected to polypharmacy, which should be assessed whenever they are evaluated for health problems, and drug interactions should be carefully checked. Physicians, pharmacists, health professionals, and health policymakers in Palestine should consider increasing citizens' health awareness and encourage healthy lifestyles to decrease the incidence of these diseases. In addition, intersectoral cooperation between the governmental and non-governmental organisations will be key in the fight against chronic diseases in older Palestinian adults.
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老年人（60岁及以上）比年轻人更容易患多种疾病，因此更频繁地使用多种药物。我们调查了巴勒斯坦人口中老年人的慢性病和医疗状况、所使用的药物以及相关的社会人口学因素。
于2013年6月至2014年1月进行了一项横断面研究。研究人群为居住在约旦河西岸和东耶路撒冷的60岁及以上的巴勒斯坦人。研究参与者采用分层随机方式选取。样本根据巴勒斯坦中央统计局的人口普查数据，按照每个省的人口规模从所有省份（层）中选取。研究团队走访并在老年人家中对其进行访谈。访谈者用通俗易懂的语言向参与者解释问卷项目，以确保完全理解，答案由访谈者记录。每位参与者均获得知情书面同意。该研究设计和方案经圣城大学研究伦理委员会修订并批准。
邀请了1574名巴勒斯坦老年成年人参与，其中1192人（76%）登记参加。平均年龄为70.3岁（标准差8.58，范围60 - 110岁）。55%（1192人中的659人）为女性，45%（533人）为男性。大多数（84%；996人）为非在职或退休人员；78%的参与者（930人）月收入低于2500新谢克尔，属于低收入群体。拥有政府医疗保险的参与者更多（78%；934人），而拥有私人保险的参与者较少（8%；89人），无保险的参与者占14%（169人）。报告了40种慢性病和疾病状况。每位参与者报告的疾病平均数量为2.33种（标准差1.68，范围0 - 11种）。心血管、内分泌和肌肉骨骼疾病是最常报告的疾病。66%的参与者（1192人中的787人）报告至少有一种心血管疾病，40%（480人）报告至少有一种内分泌疾病，32%（385人）报告至少有一种肌肉骨骼疾病。最常见的心血管疾病是高血压，影响了54%的参与者（647人）；最常见的内分泌疾病是糖尿病（38.2%，455人）；最常见的肌肉骨骼疾病是关节炎（13.7%，163人）。不同类型药物（处方药和非处方药）的总数为175种。每位参与者使用的药物平均数量为4.54种（标准差2.83），一名参与者服用的不同药物最多数量为17种。常用的治疗药物有阿司匹林（48%的参与者服用，1192人中的575人）、血管紧张素转换酶抑制剂（34%，403人）、利尿剂（34%，409人）、二甲双胍（27%，323人）、对乙酰氨基酚（23%，270人）和质子泵抑制剂（23%，275人）。
这些发现为巴勒斯坦老年人中最常见的慢性病和疾病状况以及最常用的药物提供了见解。心血管、内分泌和肌肉骨骼疾病是最常见的疾病。巴勒斯坦老年成年人面临多种药物治疗情况，每当对他们进行健康问题评估时都应进行评估，并且应仔细检查药物相互作用。巴勒斯坦的医生、药剂师、卫生专业人员和卫生政策制定者应考虑提高公民的健康意识，并鼓励健康的生活方式以降低这些疾病的发病率。此外，政府和非政府组织之间的部门间合作将是抗击巴勒斯坦老年成年人慢性病的关键。
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