Department of General Internal Medicine, Tenri Hospital, Nara, Japan.
Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan.
Mod Rheumatol. 2023 Dec 22;34(1):106-112. doi: 10.1093/mr/roac155.
This study aimed to clarify factors associated with polypharmacy among patients with systemic lupus erythematosus.
This single-centre cross-sectional study was conducted by reviewing the medical records and questionnaire data of 261 systemic lupus erythematosus patients at a teaching hospital in Japan from 1 September to 30 November 2020. Polypharmacy was defined as the regular administration of five or more oral medications; excessive polypharmacy consisted of the regular use of 10 or more oral medications. This study investigated (1) the prevalence of polypharmacy and excessive polypharmacy, (2) the distribution of medication types, and (3) the factors associated with polypharmacy and excessive polypharmacy.
The proportions of patients who exhibited polypharmacy and excessive polypharmacy were 70% and 19%, respectively. Polypharmacy was associated with older age, long duration of systemic lupus erythematosus, high disease activity, and administration of glucocorticoids or immunosuppressive agents. Excessive polypharmacy was associated with a higher updated Charlson comorbidity index, history of visits to multiple internal medicine clinics, and presence of public assistance.
Polypharmacy and excessive polypharmacy in patients with systemic lupus erythematosus are related to medical aspects such as disease severity and comorbidities in addition to social aspects such as hospital visitation patterns and economic status.
本研究旨在阐明与系统性红斑狼疮患者多种药物治疗相关的因素。
本单中心横断面研究通过回顾 2020 年 9 月 1 日至 11 月 30 日期间在日本一家教学医院的 261 例系统性红斑狼疮患者的病历和问卷调查数据进行。多种药物治疗定义为常规使用五种或以上口服药物；过度多种药物治疗包括常规使用十种或以上口服药物。本研究调查了（1）多种药物治疗和过度多种药物治疗的患病率，（2）药物类型的分布，以及（3）与多种药物治疗和过度多种药物治疗相关的因素。
出现多种药物治疗和过度多种药物治疗的患者比例分别为 70%和 19%。多种药物治疗与年龄较大、系统性红斑狼疮病程较长、疾病活动度高以及使用糖皮质激素或免疫抑制剂有关。过度多种药物治疗与更高的更新版 Charlson 合并症指数、多次就诊于多个内科诊所的病史以及享受公共援助有关。
系统性红斑狼疮患者的多种药物治疗和过度多种药物治疗与疾病严重程度和合并症等医学方面以及就诊模式和经济状况等社会方面有关。
