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药物储存、多种药物治疗和老年人衰弱综合征:一项观察性研究。

Drug storage, polypharmacy and frailty syndrome in older people: an observational study.

机构信息

Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France.

Laboratoire de Mathématiques-Informatique et Applications (LAMIA), Université des Antilles, Pointe-à-Pitre, Guadeloupe, France.

出版信息

Pan Afr Med J. 2023 May 11;45:29. doi: 10.11604/pamj.2023.45.29.32636. eCollection 2023.

Abstract

INTRODUCTION

the increasing prevalence of polypharmacy in the older population could lead to inappropriate storage of medicines at home. Since polypharmacy is associated with frailty, the main objective of the Karukera Study of Aging - Drug Storage (KASADS) study was to investigate the association between drug storage and frailty. If such an association exists, drug storage could be a simple tool for the identification of medication vulnerability by non-medical staff in the elderly.

METHODS

observational, cross-sectional study in community-dwelling older adults (>65 years old). Drug storage was defined as any drug in excess compared to a medical prescription, any unused and/or expired drug, or any drug without a medical prescription. Frailty was measured with the Study of Osteoporotic Fractures (SOF) scale, and polypharmacy was defined as a prescription of at least 5 drugs. Bivariate and multivariate analyses were performed to study the associations between drugs storage, frailty, and polypharmacy.

RESULTS

during the study period (01/10/2019 to 15/03/2020), 115 elderly people were interviewed in their own homes. The average age was 76.0 ± 7.8 years old. Seventy-two percent of the participants met the criteria for polypharmacy and 30.4% were prefrail/frail. They stored an average of 14.7 ± 18.2 boxes. Drug storage was associated with polypharmacy (17.5 boxes versus 10.0; p=0.031) but not with frailty (15.6 versus 14.3; p=0.724). In multivariate analysis, drug storage was associated with not having a school degree (OR: 1.78; 95%CI: 1.13-2.79), suffering from dyslipidemia (OR: 2.00; 95% CI: 1.28-3.17) and suffering from cognitive disorders evaluated by the Mini Mental State Examination (MMSE) score (OR: 1.10; 95%CI: 1.02-1.17).

CONCLUSION

drug storage was not significantly associated with frailty. Nevertheless, it was associated with polypharmacy and other medical outcomes, and could therefore represent a new area for research in geriatrics and pharmacy.

摘要

介绍

老年人中多药治疗的患病率不断增加,可能导致家中药物储存不当。由于多药治疗与虚弱有关,因此 Karukera 老龄化药物储存研究(KASADS)的主要目的是研究药物储存与虚弱之间的关系。如果存在这种关联,那么药物储存可能是一种由非医务人员识别老年人药物脆弱性的简单工具。

方法

对社区居住的老年人(>65 岁)进行观察性、横断面研究。药物储存的定义是任何超过医嘱的药物、任何未使用和/或过期的药物、或任何无医嘱的药物。虚弱用骨质疏松性骨折研究(SOF)量表来衡量,多药治疗定义为至少开具 5 种药物的处方。进行了单变量和多变量分析,以研究药物储存、虚弱和多药治疗之间的关系。

结果

在研究期间(2019 年 10 月 1 日至 2020 年 3 月 15 日),在家中对 115 名老年人进行了访谈。平均年龄为 76.0 ± 7.8 岁。72%的参与者符合多药治疗的标准,30.4%的参与者为虚弱前期/虚弱。他们平均储存了 14.7 ± 18.2 个盒子。药物储存与多药治疗相关(17.5 个盒子与 10.0 个盒子;p=0.031),但与虚弱无关(15.6 个盒子与 14.3 个盒子;p=0.724)。在多变量分析中,药物储存与未接受过学校教育(OR:1.78;95%CI:1.13-2.79)、患有血脂异常(OR:2.00;95%CI:1.28-3.17)和患有认知障碍(由 Mini Mental State Examination 评分评估)(OR:1.10;95%CI:1.02-1.17)相关。

结论

药物储存与虚弱无显著相关性。然而,它与多药治疗和其他医疗结果相关,因此可能代表老年病学和药学研究的一个新领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88e1/10386533/e33f8a1a202d/PAMJ-45-29-g001.jpg

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