Ebrahimoghli Reza, Janati Ali, Gharaee Hojatolah, Aghaei Mir Hossein
Department of Nursing, Institute of Health Education, Ardabil University of Medical Sciences, Ardabil, Iran.
Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Pharm Res. 2023 Feb 17;21(1):e131304. doi: 10.5812/ijpr-131304. eCollection 2022 Dec.
Polypharmacy is a significant patient safety concern.
This study aims to estimate the prevalence of polypharmacy, its continuity and associated factors, and common medication classes among a large outpatient population in East Azerbaijan province, Iran.
A retrospective prescription data analysis was performed. The cohort included all ≥ 20 years old subjects with at least one prescription filled during the main three-month study period (2020 March 1 - 2020 May 31). Polypharmacy was defined as being exposed to more than four different medications during the main study period, and continuous polypharmacy was defined as being exposed to more than four medications during both the main study period and follow-up period (2020 October 1 - 2020 December 31). The frequency and prevalence of polypharmacy, along with predictive factors, were estimated. We performed multivariate logistic regression and estimated odds ratios (ORs) to investigate the risk factors for polypharmacy.
307,820 patients included (mean age 49.8 years, 62.9% female, mean drug use 3.7 (SD = 2.6). Polypharmacy was observed in 28.3% (CI: 28.1 - 28.4), of which 36.6% experienced continuous polypharmacy. The odds of being exposed to polypharmacy increased with being female, increasing age, and exposure to chronic conditions. The groups of medications most utilized by polypharmacy patients were those indicated for gastro-esophageal reflux diseases, beta-blocking agents, antidepressants, blood glucose-lowering drugs, and antithrombotic agents.
Strategies should be formulated to inform healthcare policymakers and providers about the magnitude of the polypharmacy phenomenon, associated factors, and the common medication classes involved.
多重用药是一个重大的患者安全问题。
本研究旨在估计伊朗东阿塞拜疆省大量门诊患者中多重用药的患病率、持续性及其相关因素，以及常用药物类别。
进行回顾性处方数据分析。队列包括所有年龄≥20岁且在主要的三个月研究期间（2020年3月1日至2020年5月31日）至少有一张处方配药的受试者。多重用药定义为在主要研究期间接触超过四种不同药物，持续性多重用药定义为在主要研究期间和随访期间（2020年10月1日至2020年12月31日）均接触超过四种药物。估计多重用药的频率和患病率以及预测因素。我们进行多变量逻辑回归并估计优势比（OR）以研究多重用药的危险因素。
纳入患者307820例（平均年龄49.8岁，女性占62.9%，平均用药3.7种（标准差=2.6））。28.3%（置信区间：28.1 - 28.4）的患者存在多重用药，其中36.6%经历持续性多重用药。女性、年龄增加以及患有慢性病会增加多重用药的几率。多重用药患者最常使用的药物类别是用于胃食管反流病的药物、β受体阻滞剂、抗抑郁药、降糖药和抗血栓药。
应制定策略，让医疗保健政策制定者和提供者了解多重用药现象的严重程度、相关因素以及所涉及的常用药物类别。
