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用于治疗尿失禁的药物使用模式及潜在的不适当处方。

Patterns of use of medications used to treat urinary incontinence and potentially inappropriate prescriptions.

作者信息

Valladales-Restrepo Luis Fernando, Bedoya-Arias Hugo Alejandro, Aristizábal-Carmona Brayan Stiven, Machado-Alba Jorge Enrique

机构信息

Grupo de Investigación de Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira and Audifarma S.A., Pereira, Colombia.

Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.

出版信息

Ther Adv Urol. 2023 Jun 16;15:17562872231179104. doi: 10.1177/17562872231179104. eCollection 2023 Jan-Dec.

Abstract

BACKGROUND

The pharmacological treatment of urinary incontinence (UI) may involve bladder antimuscarinics, which can generate risks in the elderly.

OBJECTIVE

The aim was to determine the treatment patterns of a group of patients with UI and possible potentially inappropriate prescriptions.

DESIGN AND METHODS

This was a cross-sectional study that identified prescription patterns of medications for outpatient use in patients with UI between December 2020 and November 2021 based on a population database of members of the Colombian Health System. Patients were identified based on the codes of the international classification of diseases, version-10. Sociodemographic and pharmacological variables were considered.

RESULTS

A total of 9855 patients with UI were identified, with a median age of 72 years, and 74.6% were women. Unspecified UI was the most frequent form (83.2%), followed by specified UI (7.9%), stress UI (6.7%), and UI associated with an overactive bladder (2.2%). A total of 37.2% received pharmacological treatment, mainly with bladder antimuscarinics (22.6%), mirabegron (15.6%), and topical estrogens (7.9%). Pharmacological management predominated in UI associated with overactive bladder, in women and in patients between 50 and 79 years of age. Of the patients who received bladder antimuscarinics, 54.5% were 65 years old or older, and 21.5% also had benign prostatic hyperplasia, sicca syndrome, glaucoma, constipation, or dementia. A total of 2.0% of women had been prescribed systemic estrogens and 1.7% had been prescribed peripheral α-adrenergic antagonists.

CONCLUSION

Differences in the prescriptions were found according to the type of UI, sex, and age group. Potentially inappropriate or risky prescriptions were common.

摘要

背景

尿失禁(UI)的药物治疗可能涉及膀胱抗毒蕈碱药物,这可能给老年人带来风险。

目的

旨在确定一组尿失禁患者的治疗模式以及可能存在的潜在不适当处方。

设计与方法

这是一项横断面研究,基于哥伦比亚卫生系统成员的人口数据库,确定2020年12月至2021年11月期间门诊尿失禁患者的药物处方模式。根据国际疾病分类第10版的编码识别患者。考虑了社会人口统计学和药理学变量。

结果

共识别出9855例尿失禁患者,中位年龄为72岁,74.6%为女性。未明确的尿失禁是最常见的类型(83.2%),其次是明确的尿失禁(7.9%)、压力性尿失禁(6.7%)和膀胱过度活动症相关的尿失禁(2.2%)。共有37.2%的患者接受了药物治疗,主要使用膀胱抗毒蕈碱药物(22.6%)、米拉贝隆(15.6%)和局部雌激素(7.9%)。药物治疗在膀胱过度活动症相关的尿失禁、女性以及50至79岁的患者中占主导地位。在接受膀胱抗毒蕈碱药物治疗的患者中,54.5%为65岁及以上,21.5%还患有良性前列腺增生、干燥综合征、青光眼、便秘或痴呆。共有2.0%的女性被处方使用全身雌激素,1.7%的女性被处方使用外周α-肾上腺素能拮抗剂。

结论

根据尿失禁类型、性别和年龄组发现了处方差异。潜在不适当或有风险的处方很常见。

相似文献

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[Possible relationship between prescription medications and urinary dysfunction in elderly home health care patients].
Nihon Ronen Igakkai Zasshi. 2019;56(3):301-311. doi: 10.3143/geriatrics.56.301.

本文引用的文献

7
The cognitive safety of antimuscarinics in the treatment of overactive bladder.抗毒蕈碱药物治疗膀胱过度活动症的认知安全性。
Expert Opin Drug Saf. 2020 Oct;19(10):1303-1313. doi: 10.1080/14740338.2020.1817377. Epub 2020 Sep 8.

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