Shin Woo-Young, Go Tae-Hwa, Kang Dae Ryong, Lee Sei Young, Lee Won, Kim Seonah, Lee Jiewon, Kim Jung-Ha
Department of Family Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Sci Rep. 2022 Oct 27;12(1):18073. doi: 10.1038/s41598-022-23032-z.
Polypharmacy and its rising global prevalence is a growing public health burden. Using a large representative nationwide Korean cohort (N = 761,145), we conducted a retrospective cross-sectional study aiming to identify subpopulations of patients with polypharmacy and characterize their unique patterns through cluster analysis. Patients aged ≥ 30 years who were prescribed at least one medication between 2014 and 2018 were included in our study. Six clusters were identified: cluster 1 mostly included patients who were hospitalized for a long time (4.3 ± 5.3 days); cluster 2 consisted of patients with disabilities (100.0%) and had the highest mean number of prescription drugs (7.7 ± 2.8 medications); cluster 3 was a group of low-income patients (99.9%); cluster 4 was a group of high-income patients (80.2%) who frequently (46.4 ± 25.9 days) visited hospitals/clinics (7.3 ± 2.7 places); cluster 5 was mostly elderly (74.9 ± 9.8 years) females (80.3%); and cluster 6 comprised mostly middle-aged (56.4 ± 1.5 years) males (88.6%) (all P < 0.001). Patients in clusters 1-5 had more prescribed medications and outpatient visit days than those in cluster 6 (all P < 0.001). Given limited health care resources, individuals with any of the identified phenotypes may be preferential candidates for participation in intervention programs for optimal medication use.
多重用药及其在全球范围内不断上升的患病率是一个日益严重的公共卫生负担。我们利用一个具有全国代表性的大型韩国队列（N = 761,145）进行了一项回顾性横断面研究，旨在识别多重用药患者的亚群，并通过聚类分析描述其独特模式。年龄≥30岁且在2014年至2018年间至少开具过一种药物的患者纳入我们的研究。识别出六个聚类：聚类1主要包括长期住院患者（4.3±5.3天）；聚类2由残疾患者组成（100.0%），平均处方药数量最高（7.7±2.8种药物）；聚类3是低收入患者群体（99.9%）；聚类4是高收入患者群体（80.2%），他们频繁（46.4±25.9天）就诊于医院/诊所（7.3±2.7个地点）；聚类5主要是老年女性（74.9±9.8岁，80.3%）；聚类6主要是中年男性（56.4±1.5岁，88.6%）（所有P < 0.001）。聚类1至5的患者比聚类6的患者开具的药物更多，门诊就诊天数也更多（所有P < 0.001）。鉴于医疗保健资源有限，具有任何已识别表型的个体可能是参与优化用药干预项目的优先人选。
