埃塞俄比亚西北部肿瘤中心老年癌症患者的多重用药及潜在不适当用药情况：一项多中心横断面研究

Polypharmacy and potentially inappropriate medicine use in older adults with cancer: a multicenter cross-sectional study in Northwest Ethiopia oncologic centers.

作者信息

Wondm Samuel Agegnew, Moges Tilaye Arega, Dagnew Samuel Berihun, Dagnew Fisseha Nigussie, Zeleke Tirsit Ketsela, Abebe Rahel Belete, Mihrete Endalamaw Aschale, Bayafers Tamene Fasil

机构信息

Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

J Pharm Policy Pract. 2024 Oct 1;17(1):2397797. doi: 10.1080/20523211.2024.2397797. eCollection 2024.

DOI:10.1080/20523211.2024.2397797

PMID:39359864

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11445903/

Abstract

BACKGROUND

Most patients with cancer have comorbid conditions that necessitate advanced medical treatment. Polypharmacy (PP) and potentially inappropriate medicine (PIM) use is common among older adult patients with cancer. Not much research has been conducted on PP and PIM use among older adult patients with cancer in Ethiopian oncology centers. Therefore, this study aimed to evaluate the prevalence and determinants of PP and PIM use among older adults with cancer in Northwest Ethiopia oncology centers using the American Geriatrics Society (AGS) 2019 updated Beers criteria.

METHODS

This multicenter cross-sectional study was conducted among older adult patients with cancer from July 15-December 30, 2023 in Northwest Ethiopian oncology centers. The use of at least one drug included in the 2019 Beers criteria revisions was classified as potentially inappropriate medication use. To identify the factors influencing PP and PIM use, logistic regression analysis was performed.

RESULTS

Of the 310 samples aproched, 305(98.4% response rate) participated in the study. The prevalence of PP and PIM use were 70.2% (95% CI 64.9-75.1) and 63.0% (95% CI 57.4-68.8) respectively. Being female AOR:3.6; 95% CI:1.7-7.8; p = 0. 001, advanced age [(70-74 years) AOR:3.9; 95% CI:1.2-6.7; p = 0.046 and ≥75 years AOR:3.8; 95% CI:1.7-8.4; p = 0.0028], abnormal body weight (underweight AOR:5.5; 95% CI:1.5-9.6; p = 0.019, overweight AOR:5.1; 95% CI:1.5-7.3; p = 0.01 and obese AOR:5.6; 95% CI:1.5-9.3; p = 0.021) and comorbidities AOR:3.5; 95% CI:1.7-8.3; p = 0.0032 were statistically significant factors for PP. Advanced age [(70-74 years) AOR:5.5; 95% CI:1.4-9.8; p = 0.015 and ≥75 years AOR:3.3; 95% CI:1.5-7.1; p = 0.002)] and polypharmacy; AOR:7; 95% CI:3.4-9.4; p = 0.001 were statistically significant factors for PIM use.

CONCLUSION

Polypharmacy and potentially inappropriate medicine use were prevalent among older adult patients with cancer. Ensuring safe medicines prescription practices for older patients with cancer requires understanding the issue, stopping unwarranted treatment, and replacing it with less toxic, age-appropriate medicines.

摘要

背景

大多数癌症患者患有需要先进医疗治疗的合并症。在老年癌症患者中，多重用药（PP）和潜在不适当用药（PIM）的情况很常见。在埃塞俄比亚肿瘤中心，针对老年癌症患者的PP和PIM使用情况的研究较少。因此，本研究旨在使用美国老年医学会（AGS）2019年更新的Beers标准，评估埃塞俄比亚西北部肿瘤中心老年癌症患者中PP和PIM使用的患病率及影响因素。

方法

本多中心横断面研究于2023年7月15日至12月30日在埃塞俄比亚西北部肿瘤中心的老年癌症患者中进行。使用2019年Beers标准修订版中包含的至少一种药物被归类为潜在不适当用药。为确定影响PP和PIM使用的因素，进行了逻辑回归分析。

结果

在纳入的310个样本中，305个（应答率98.4%）参与了研究。PP和PIM使用的患病率分别为70.2%（95%CI 64.9 - 75.1）和63.0%（95%CI 57.4 - 68.8）。女性（优势比[AOR]：3.6；95%CI：1.7 - 7.8；p = 0.001）、高龄（[70 - 74岁]AOR：3.9；95%CI：1.2 - 6.7；p = 0.046，≥75岁AOR：3.8；95%CI：1.7 - 8.4；p = 0.0028]）、体重异常（体重过轻AOR：5.5；95%CI：1.5 - 9.6；p = 0.019，超重AOR：5.1；95%CI：1.5 - 7.3；p = 0.01，肥胖AOR：5.6；95%CI：1.5 - 9.3；p = 0.021）和合并症（AOR：3.5；95%CI：1.7 - 8.3；p = 0.0032）是PP的统计学显著影响因素。高龄（[70 - 74岁]AOR：5.5；95%CI：1.4 - 9.8；p = 0.015，≥75岁AOR：3.3；95%CI：1.5 - 7.1；p = 0.002）和多重用药（AOR：7；95%CI：3.）是PIM使用的统计学显著影响因素。