Reinhild Haerig Theresa, Krause Dietmar, Klaassen-Mielke Renate, Rudolf Henrik, Trampisch Hans Joachim, Thuermann Petra
Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany.
Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Rostock, Germany.
Front Pharmacol. 2023 Feb 15;14:1062290. doi: 10.3389/fphar.2023.1062290. eCollection 2023.
With growing age, multiple chronic diseases may result in polypharmacy. Drugs that should be avoided in older adults are called potentially inappropriate medications (PIM). Beyond PIM, drug-drug interactions (DDI) are known to be related to adverse drug events. This analysis examines the risk of frequent falling, hospital admission, and death in older adults associated with PIM and/or DDI (PIM/DDI) prescription. This analysis used data of a subgroup of the getABI study participants, a large cohort of community-dwelling older adults. The subgroup comprised 2120 participants who provided a detailed medication report by telephone interview at the 5-year getABI follow-up. The risks of frequent falling, hospital admission, and death in the course of the following 2 years were analysed by logistic regression in uni- and multivariable models with adjustment for established risk factors. Data of all 2,120 participants was available for the analysis of the endpoint death, of 1,799 participants for hospital admission, and of 1,349 participants for frequent falling. The multivariable models showed an association of PIM/DDI prescription with frequent falling (odds ratio (OR) 1.66, 95% confidence interval (CI) 1.06-2.60, = 0.027) as well as with hospital admission (OR 1.29, 95% CI 1.04-1.58, = 0.018), but not with death (OR 1.00, 95% CI 0.58-1.72, = 0.999). PIM/DDI prescription was associated with the risk of hospital admission and frequent falling. No association was found with death by 2 years. This result should alert physicians to provide a closer look at PIM/DDI prescriptions.
随着年龄增长，多种慢性疾病可能导致多重用药。老年人应避免使用的药物被称为潜在不适当药物（PIM）。除PIM外，已知药物相互作用（DDI）与药物不良事件有关。本分析研究了与PIM和/或DDI（PIM/DDI）处方相关的老年人频繁跌倒、住院和死亡风险。本分析使用了getABI研究参与者亚组的数据，该研究是一个由居住在社区的大量老年人组成的队列。该亚组包括2120名参与者，他们在getABI研究5年随访时通过电话访谈提供了详细的用药报告。在单变量和多变量模型中，通过逻辑回归分析了在接下来2年中频繁跌倒、住院和死亡的风险，并对既定风险因素进行了调整。所有2120名参与者的数据可用于分析终点死亡情况，1799名参与者的数据可用于分析住院情况，1349名参与者的数据可用于分析频繁跌倒情况。多变量模型显示，PIM/DDI处方与频繁跌倒（比值比（OR）1.66，95%置信区间（CI）1.06 - 2.60，P = 0.027）以及住院（OR 1.29，95%CI 1.04 - 1.58，P = 0.018）相关，但与死亡无关（OR 1.00，95%CI 0.58 - 1.72，P = 0.999）。PIM/DDI处方与住院风险和频繁跌倒相关。2年内未发现与死亡相关。这一结果应提醒医生仔细查看PIM/DDI处方。
