Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.
Department of Clinical Pharmacy, School of Medicine, Fujita Health University, Toyoake, Japan.
Geriatr Gerontol Int. 2022 Feb;22(2):121-126. doi: 10.1111/ggi.14326. Epub 2021 Dec 20.
Elderly patients with musculoskeletal disorders are generally expected to receive many prescription drugs for non-musculoskeletal comorbidities and for alleviating chronic musculoskeletal pains. The aims of this study were to review the use of prescription drugs in elderly patients with elective surgeries for musculoskeletal disorders and to identify the factors associated with polypharmacy in elderly patients with musculoskeletal disorders.
We retrospectively collected the clinical data of patients aged ≥65 years who underwent knee arthroplasty, total hip arthroplasty, or spinal surgery for lumbar or cervical degenerative disorders at our institution. The following data were evaluated: age, body mass index, sex, surgical site, prescription drugs used, American Society of Anesthesiologists physical status grade, and medical history, including hypertension, hyperlipidemia, diabetes, stroke, malignancy, and smoking. Polypharmacy was defined as the use of six or more drugs.
In the present study, 767 consecutive patients were evaluated retrospectively. The prevalence of polypharmacy was >50% in the elderly patients with musculoskeletal disorders. The mean numbers of total drugs and pain relief medications were significantly higher in the lumbar surgery group than in the other surgery groups. Multivariable analysis revealed that the factors associated with polypharmacy were lumbar surgery, hypertension, hyperlipidemia, diabetes, and malignancy.
This is the first study to cross-sectionally review the drugs prescribed to patients with degenerative musculoskeletal disorders. It clearly identified the factors associated with polypharmacy in elderly patients with degenerative musculoskeletal disorders. Particular attention should be paid to polypharmacy in elderly patients with lumbar degenerative disorders. Geriatr Gerontol Int 2022; 22: 121-126.
患有肌肉骨骼疾病的老年患者通常需要接受许多治疗非肌肉骨骼合并症和缓解慢性肌肉骨骼疼痛的处方药物。本研究旨在回顾接受肌肉骨骼疾病择期手术的老年患者的处方药物使用情况,并确定与肌肉骨骼疾病老年患者多药治疗相关的因素。
我们回顾性收集了在我院行膝关节置换术、全髋关节置换术或腰椎或颈椎退行性疾病脊柱手术的年龄≥65 岁患者的临床资料。评估了以下数据:年龄、体重指数、性别、手术部位、使用的处方药物、美国麻醉医师协会身体状况分级以及包括高血压、高血脂、糖尿病、中风、恶性肿瘤和吸烟史在内的病史。多药治疗定义为使用六种或更多种药物。
在本研究中,共回顾性评估了 767 例连续患者。患有肌肉骨骼疾病的老年患者中多药治疗的患病率>50%。与其他手术组相比,腰椎手术组患者使用的总药物和止痛药物数量明显更多。多变量分析显示,与多药治疗相关的因素为腰椎手术、高血压、高血脂、糖尿病和恶性肿瘤。
这是第一项对退行性肌肉骨骼疾病患者开具的药物进行横断面回顾的研究。它明确确定了与退行性肌肉骨骼疾病老年患者多药治疗相关的因素。应特别注意腰椎退行性疾病老年患者的多药治疗。老年医学与老年病学杂志 2022; 22: 121-126。