Department of General Internal Medicine, Tenri Hospital, 200 Mishima, Tenri, Nara, 632-8552, Japan.
Department of Infection Control, Graduate School of Medicine, Osaka University, Osaka, Japan.
Clin Rheumatol. 2023 Sep;42(9):2287-2295. doi: 10.1007/s10067-023-06646-0. Epub 2023 May 27.
This study aimed to identify factors associated with polypharmacy, including social aspects, among patients with rheumatoid arthritis.
We conducted this single-centre, cross-sectional study at a 715-bed regional tertiary care teaching hospital in Japan from 1 September to 30 November 2020. Polypharmacy was defined as having five or more medications administered orally regularly, and excessive polypharmacy was defined as having 10 or more medications administered orally regularly. The prevalence of polypharmacy and excessive polypharmacy, distribution of medication types, and factors associated with polypharmacy and excessive polypharmacy were investigated among patients with rheumatoid arthritis.
The proportions of polypharmacy and excessive polypharmacy were 61% and 15%, respectively, in 991 patients. Polypharmacy and excessive polypharmacy were associated with older age (odds ratio, 1.03 and 1.03, respectively), high Health Assessment Questionnaire Disability Index (odds ratio, 1.45 and 2.03, respectively), medication with glucocorticoids (odds ratio, 5.57 and 2.42, respectively), high Charlson comorbidity index (odds ratio, 1.28 and 1.36, respectively), and a history of hospitalisation in internal medicine (odds ratio, 1.92 and 1.87, respectively) and visits to other internal medicine clinics (odds ratio, 2.93 and 2.03, respectively). Moreover, excessive polypharmacy was associated with the presence of public assistance (odds ratio, 3.80).
Considering that polypharmacy and excessive polypharmacy are associated with a history of hospitalisation and glucocorticoid medication in patients with rheumatoid arthritis, medications during hospitalisation should be monitored, and glucocorticoids should be discontinued. Key points • The proportion of polypharmacy (five or more medications administered orally regularly) was 61%. • The proportion of excessive polypharmacy (10 or more medications administered orally regularly) was 15%. • Medications during hospitalisation should be reviewed and examined, and glucocorticoids should be discontinued.
本研究旨在确定与类风湿关节炎患者多药治疗相关的因素，包括社会方面。
我们于 2020 年 9 月 1 日至 11 月 30 日在日本一家拥有 715 张床位的地区性三级教学医院进行了这项单中心、横断面研究。多药治疗定义为口服常规给予五种或更多种药物，过度多药治疗定义为口服常规给予十种或更多种药物。调查了类风湿关节炎患者的多药治疗和过度多药治疗的患病率、药物类型分布以及与多药治疗和过度多药治疗相关的因素。
在 991 例患者中，多药治疗和过度多药治疗的比例分别为 61%和 15%。多药治疗和过度多药治疗与年龄较大（比值比分别为 1.03 和 1.03）、较高的健康评估问卷残疾指数（比值比分别为 1.45 和 2.03）、糖皮质激素药物治疗（比值比分别为 5.57 和 2.42）、较高的 Charlson 合并症指数（比值比分别为 1.28 和 1.36）以及内科住院史（比值比分别为 1.92 和 1.87）和其他内科诊所就诊史（比值比分别为 2.93 和 2.03）相关。此外，过度多药治疗与公共援助的存在相关（比值比为 3.80）。
考虑到多药治疗和过度多药治疗与类风湿关节炎患者的住院和糖皮质激素治疗史相关，应监测住院期间的药物治疗，并停止使用糖皮质激素。关键点•多药治疗（口服常规给予五种或更多种药物）的比例为 61%。•过度多药治疗（口服常规给予十种或更多种药物）的比例为 15%。•应审查和检查住院期间的药物治疗，并停止使用糖皮质激素。
Zotero 插件