Department of Family Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
BMC Geriatr. 2024 Jun 21;24(1):542. doi: 10.1186/s12877-024-05141-8.
Polypharmacy is a global public health concern. This study aimed to determine the prevalence of polypharmacy and trends in the use of commonly used and potentially inappropriate medications among older Korean patients.
Individuals aged ≥ 65 years who were prescribed any medication between 2014 and 2018 were selected from the Korean National Health Information Database. Joinpoint regression analyses were used to determine trends in the age-adjusted polypharmacy rates by age group. The prescription rates of the most commonly used medications and the most commonly used potentially inappropriate medications were analysed by year or age group for patients with polypharmacy using the chi-square and proportion difference tests.
This study included 1,849,968 patients, 661,206 (35.7%) of whom had polypharmacy. Age-adjusted polypharmacy rates increased significantly between 2014 and 2018 (P = 0.046). Among patients with polypharmacy, the most commonly prescribed medications were aspirin (100 mg), atorvastatin, metformin, glimepiride, and rosuvastatin. The most commonly prescribed and potentially inappropriate medications were alprazolam, diazepam, amitriptyline, zolpidem, and dimenhydrinate. There was a significant decrease in the prescription rates for each of these drugs in 2018 compared with 2014 among patients with polypharmacy (all P < 0.001), whereas there was a significant increase in alprazolam prescription among patients aged ≥ 85 years when analysed by age group (P < 0.001).
This study revealed an increasing prevalence of polypharmacy among older adults. Additionally, it highlighted that the utilisation of commonly prescribed potentially inappropriate medications, such as benzodiazepines and tricyclic antidepressants, has remained persistent, particularly among patients aged ≥ 85 years who practiced polypharmacy. These findings provide evidence-based guidance for the development of robust polypharmacy management strategies to ensure medication safety among older adults.
多种药物疗法是一个全球性的公共卫生问题。本研究旨在确定韩国老年患者中多种药物疗法的流行率以及常用和潜在不适当药物使用的趋势。
从韩国国家健康信息数据库中选择 2014 年至 2018 年期间接受任何药物治疗的年龄≥65 岁的个体。使用 Joinpoint 回归分析按年龄组确定年龄调整后多种药物疗法的发生率趋势。使用卡方检验和比例差异检验分析患有多种药物疗法的患者按年份或年龄组分析最常用药物和最常用潜在不适当药物的处方率。
本研究共纳入 1849968 例患者，其中 661206 例（35.7%）患有多种药物疗法。2014 年至 2018 年间，年龄调整后的多种药物疗法发生率显著增加（P=0.046）。在患有多种药物疗法的患者中，最常开的药物是阿司匹林（100mg）、阿托伐他汀、二甲双胍、格列美脲和罗苏伐他汀。最常开的和潜在不适当的药物是阿普唑仑、地西泮、阿米替林、唑吡坦和茶苯海明。与 2014 年相比，2018 年患有多种药物疗法的患者中这些药物的处方率均显著下降（均 P<0.001），而按年龄组分析时，85 岁及以上患者的阿普唑仑处方率显著增加（P<0.001）。
本研究揭示了老年人中多种药物疗法的流行率不断增加。此外，研究结果还强调了常用的潜在不适当药物（如苯二氮䓬类和三环抗抑郁药）的使用仍然持续存在，尤其是在患有多种药物疗法的 85 岁及以上的患者中。这些发现为制定强有力的多种药物疗法管理策略提供了循证指导，以确保老年人的药物安全。
