Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal.
Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal.
Int J Environ Res Public Health. 2022 Oct 10;19(19):12938. doi: 10.3390/ijerph191912938.
Multiple medication intake by older adults is considered a serious public health concern since it is associated with increased risk of adverse drug reactions and potentially inappropriate medication (PIM). This study described the top-10 prescribed active substances considering geographical distribution and PIM prescription in older adults. A cross-sectional ecological study using data on the active substances prescribed to people aged 65 years or older during 2020 was conducted. Information on active substances and the respective defined daily doses (DDD) stratified by age group, sex and region were collected from a Portuguese health administrative database. The average number of prescribed packages and DDD per 1000 inhabitants per day of top-10 active substances were assessed. This study included a total of 2,228,090 older adults (58% females). The furosemide and atorvastatin were the active substances with higher prescription rates (mean DDD/1000 inhabitants/day) in all ARS in both males and females, in comparison with the other top-10 active substances. Our results showed geographic differences in prescription, illustrated by more prescriptions in ARS North and Centre and fewer prescriptions in ARS Algarve. In females, two out of the 10 most prescribed active substances were PIM (benzodiazepines and opioids). Geographic disparities in PIM prescription across Portuguese regions were also observed. This study shows that drugs for the cardiovascular system were the active substances most prescribed to older adults. The prescription of benzodiazepines and opioids, classified as PIM, among females, alerts officials to the need of health policies to decrease inappropriate medication. The observed geographic differences in the 10 most prescribed active substances and in PIM prescription emphasized the importance of investing in medication optimization across the Portuguese regions.
老年人同时服用多种药物被认为是一个严重的公共卫生问题，因为这会增加不良反应和潜在不适当药物（PIM）的风险。本研究描述了考虑到地理分布和老年人 PIM 处方的情况下，排名前十的处方活性物质。这是一项使用 2020 年为 65 岁及以上人群开具的活性物质数据的横断面生态研究。从葡萄牙卫生行政数据库中收集了按年龄组、性别和地区分层的活性物质和相应的定义日剂量（DDD）信息。评估了排名前十的活性物质中每 1000 名居民每天处方的平均包装数和 DDD。本研究共纳入 2228090 名老年人（58%为女性）。与其他排名前十的活性物质相比，呋塞米和阿托伐他汀在所有地区老年人中（男性和女性）的处方率（平均 DDD/1000 居民/天）更高。我们的结果显示了处方的地域差异，北部和中部地区的处方更多，而阿尔加维地区的处方更少。在女性中，十种最常开的药物中有两种是 PIM（苯二氮䓬类和阿片类药物）。还观察到葡萄牙各地区 PIM 处方的地域差异。本研究表明，心血管系统药物是开给老年人的最常用的活性物质。女性开苯二氮䓬类和阿片类药物，被归类为 PIM，这提醒有关部门需要制定健康政策来减少不适当的药物治疗。观察到排名前十的活性物质和 PIM 处方的地域差异，强调了在葡萄牙各地区投资药物优化的重要性。
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