Gharekhani Afshin, Somi Mohammadhossein, Ostadrahimi Alireza, Hatefi Ayda, Haji Kamanaj Arash, Hassannezhad Sina, Faramarzi Elnaz
Department of Clinical Pharmacy (Pharmacotherapy), Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Pharm Res. 2022 May 8;21(1):e126922. doi: 10.5812/ijpr-126922. eCollection 2022 Dec.
As polypharmacy has some medically negative impacts, it has become a challenging issue for public health and affected people. Therefore, we decided to investigate the prevalence of polypharmacy and its predicting risk factors in the Azar cohort population.
In this cross-sectional population-based cohort study, the prevalence of polypharmacy was evaluated in 15,001 subjects who participated in the Azar cohort study. We measured demographic characteristics (age, gender, socioeconomic status, smoking status, marital status, and education level), physical activity level, body mass index (BMI), blood pressure, multimorbidity (coexistence of two or more chronic diseases (CDs)), and polypharmacy status (a daily intake of five or more medicines for a minimum of 90 days).
Based on our results, 9.51% of the population had polypharmacy. The five most prescribed medications were drugs acting on the cardiovascular system (19.9%), central nervous system (16.7%), endocrine system (13.3%), NSAIDs (11.5%), and drugs used for musculoskeletal and joint diseases (11.4%). Being female, illiterate, and having the lowest tertile of physical activity level significantly increased the risk of polypharmacy. The risk of polypharmacy was 49.36 times higher in patients with four or more CDs than in those without.
Our study emphasized the importance of routine monitoring to evaluate polypharmacy among those aged 35 to 59 and the elderly. Physicians should carefully assess drug suitability, especially in multimorbid and obese patients, to prevent excessive polypharmacy and its potentially negative impacts.
由于多重用药存在一些医学上的负面影响，它已成为公共卫生领域的一个具有挑战性的问题，并影响到人们。因此，我们决定调查阿扎尔队列人群中多重用药的患病率及其预测风险因素。
在这项基于人群的横断面队列研究中，对参与阿扎尔队列研究的15001名受试者的多重用药患病率进行了评估。我们测量了人口统计学特征（年龄、性别、社会经济地位、吸烟状况、婚姻状况和教育水平）、身体活动水平、体重指数（BMI）、血压、多种疾病并存情况（两种或更多种慢性病（CD）并存）以及多重用药状况（每天服用五种或更多种药物至少90天）。
根据我们的结果，9.51%的人群存在多重用药情况。最常开具的五种药物是作用于心血管系统的药物（19.9%）、中枢神经系统的药物（16.7%）、内分泌系统的药物（13.3%）、非甾体抗炎药（11.5%）以及用于肌肉骨骼和关节疾病的药物（11.4%）。女性、文盲以及身体活动水平处于最低三分位数的人群多重用药风险显著增加。患有四种或更多种慢性病的患者多重用药风险比未患慢性病的患者高49.36倍。
我们的研究强调了对35至59岁人群和老年人进行常规监测以评估多重用药情况的重要性。医生应仔细评估药物适用性，尤其是在患有多种疾病和肥胖的患者中，以防止过度多重用药及其潜在的负面影响。
