Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.
Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan.
BMC Res Notes. 2021 Sep 20;14(1):367. doi: 10.1186/s13104-021-05787-2.
Polypharmacy and multi-drug prescription are major public health problems in Japan, but only a few studies have investigated the regional differences. By revealing regional differences in the multi-drug prescriptions, we can infer regions with high rates of multimorbidity or inappropriate prescribing. This study revealed regional differences in multi-drug prescriptions (the number of simultaneous prescriptions of seven or more internal medicines) and investigated the factors affecting the difference using the National Database of Health Insurance Claims and Specific Health Checkups of Japan data.
The standardized claim ratio (SCR) of the number of multi-drug prescriptions, which corrected the difference in sex and age distribution of prefectures, varied depending on prefectures. A panel data analysis investigating the association between the SCR and explanatory variables (Medical institutions, socioeconomic factors, and physical characteristics of people in prefectures) revealed that the number of public assistance recipients per 1,000 persons was positively and significantly associated with the SCR (Standardized partial regression coefficient = 0.244, p-value = 0.038). In conclusion, regional differences in the number of the multi-drug prescriptions were revealed in Japan, suggesting that public assistance recipients tend to experience multi-drug prescriptions.
药物滥用和多药处方是日本的主要公共卫生问题，但只有少数研究调查了区域差异。通过揭示多药处方的区域差异，我们可以推断出多发病或不当处方率较高的地区。本研究利用日本国民健康保险索赔和特定健康检查全国数据库揭示了多药处方（同时开具七种或更多种内科药物的处方数）的区域差异，并调查了使用这些数据影响差异的因素。
标准化索赔率（SCR）校正了各县市性别和年龄分布差异的多药处方数量存在差异。对 SCR 与解释变量（医疗机构、社会经济因素和各县市人口的身体特征）之间的关联进行的面板数据分析表明，每 1000 人中接受公共援助的人数与 SCR 呈正相关且显著相关（标准化部分回归系数=0.244，p 值=0.038）。总之，日本揭示了多药处方数量的区域差异，表明接受公共援助的人往往会经历多药处方。
