Department of Preventive Medicine, Shantou University Medical College, Shantou, China.
Shenzhen Health Development Research and Data Management Center, Shenzhen, China.
Front Public Health. 2022 Sep 20;10:995948. doi: 10.3389/fpubh.2022.995948. eCollection 2022.
Potentially inappropriate medications had been found associated with adverse drug events such as falls, emergency department admissions and hospital readmissions. There is lack of information about the prevalence of potentially inappropriate medications and associated chronic conditions in older patients with diabetes in China. This study aimed to assess the prevalence of potentially inappropriate medications in older adults with diabetes in an outpatient visitation setting and the association with polypharmacy due to comorbidities.
This was a 3-year repeated cross-sectional study which conducted in outpatient setting of 52 hospitals in Shenzhen, China, using 2019 Beers criteria. The prevalence of potentially inappropriate medications, polypharmacy and comorbidities in older adults with diabetes in an outpatient setting was expressed as percentages. Logistic models were used to investigate the association between potentially inappropriate medication exposure and age, sex, polypharmacy and comorbidities.
Among the 28,484 older adults with diabetes in 2015, 31,757 in 2016 and 24,675 in 2017, the prevalence of potentially inappropriate medications was 43.2%, 44.88% and 42.40%, respectively. The top five potentially inappropriate medications were diuretics (20.56%), benzodiazepines (13.85%), androgens (13.18%), non-steroidal anti-inflammatory drugs (12.94%) and sulfonylureas (6.23%). After adjustment for age and polypharmacy, the probability of potentially inappropriate medication exposure was associated with chronic gastrointestinal diseases, followed by osteoarthritis and rheumatoid arthritis, chronic pulmonary disease, chronic kidney disease, tumor, dementia, chronic liver disease, hypertension, cardiovascular disease, cerebrovascular disease and hyperlipemia.
Potentially inappropriate medications were common in older patients with diabetes in an outpatient visitation setting. Higher probability of potentially inappropriate medication exposure was associated with the comorbidity chronic gastrointestinal diseases as well as osteoarthritis and rheumatoid arthritis. To ensure that iatrogenic risks remain minimal for older adults with diabetes, the clinical comorbidities should be considered.
研究表明，不适当的药物与跌倒、急诊科就诊和再次住院等不良药物事件有关。中国缺乏关于糖尿病老年患者中潜在不适当药物及相关慢性疾病流行率的信息。本研究旨在评估在门诊就诊环境中，老年糖尿病患者中潜在不适当药物的流行率，并评估其与因合并症而导致的多种药物治疗的关系。
这是一项为期 3 年的重复横断面研究，在中国深圳的 52 家医院的门诊环境中进行，使用 2019 年 Beers 标准。用百分数表示在门诊就诊环境中患有糖尿病的老年患者中潜在不适当药物、多种药物治疗和合并症的流行率。使用逻辑模型调查潜在不适当药物暴露与年龄、性别、多种药物治疗和合并症之间的关系。
在 2015 年、2016 年和 2017 年的 28484 例老年糖尿病患者中，潜在不适当药物的流行率分别为 43.2%、44.88%和 42.40%。排名前五的潜在不适当药物分别为利尿剂（20.56%）、苯二氮䓬类（13.85%）、雄激素（13.18%）、非甾体抗炎药（12.94%）和磺脲类（6.23%）。在调整年龄和多种药物治疗后，潜在不适当药物暴露的可能性与慢性胃肠道疾病相关，其次是骨关节炎和类风湿关节炎、慢性肺部疾病、慢性肾病、肿瘤、痴呆、慢性肝病、高血压、心血管疾病、脑血管疾病和高脂血症。
在门诊就诊环境中，患有糖尿病的老年患者中潜在不适当药物很常见。潜在不适当药物暴露的可能性更高与合并慢性胃肠道疾病以及骨关节炎和类风湿关节炎相关。为了确保糖尿病老年患者的医源性风险保持在最低水平，应考虑临床合并症。
