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探索瑞士全科医生和患者对膳食补充剂使用和减药的态度:一项调查研究。

Exploring GP and patient attitudes towards the use and deprescribing of dietary supplements: a survey study in Switzerland.

机构信息

Institute of Primary Health Care (BIHAM), University of Bern, Bern, 3012, Switzerland.

Graduate School for Health Sciences, University of Bern, Bern, 3012, Switzerland.

出版信息

BMC Prim Care. 2024 Oct 3;25(1):359. doi: 10.1186/s12875-024-02605-z.

Abstract

BACKGROUND

Dietary supplements are commonly used by older adults, but their inappropriate use may lead to adverse events. To optimise medication use, general practitioners (GPs) ideally are aware of all substances that patients use, including supplements. This cross-sectional study explored the use of dietary supplements by older patients with polypharmacy, the rate at which they disclosed this use to their GPs, and compared patients' and GPs' attitudes towards discontinuing dietary supplements.

METHODS

Ten GPs in Swiss primary care recruited five to ten of their older patients taking ≥ 5 regular medications. Both GPs and their patients completed a survey on patients' use of dietary supplements and attitudes towards deprescribing those. We described and compared their responses. We assessed the association of supplement disclosure with patient characteristics using multilevel logistic regression analysis.

RESULTS

Three out of ten GPs (30%) were female, and GPs' average age was 52 years (SD = 8). 45% of patients were female (29/65). Most patients (n = 45, 70%) were taking ≥ 1 supplement. On average, patients reported to be using three supplements (SD = 2). In 60% (n = 39) of patients, GPs were unaware of ≥ 1 supplement used. We did not find evidence for an association between supplement disclosure to GPs and patient characteristics. Only 8% (n = 5) of patients and 60% (n = 6) of GPs reported ≥ 1 supplement they would be willing to deprescribe and none of the supplements reported by GPs and patients to deprescribe matched.

CONCLUSION

Swiss GPs were unaware of many dietary supplements used by their older patients, which may affect medication optimisation efforts.

摘要

背景

膳食补充剂在老年人中很常见,但使用不当可能会导致不良事件。为了优化药物使用,全科医生(GP)理想情况下应了解患者使用的所有物质,包括补充剂。本横断面研究探讨了服用多种药物的老年患者使用膳食补充剂的情况、他们向 GP 披露这些使用情况的频率,并比较了患者和 GP 对停止使用膳食补充剂的态度。

方法

瑞士初级保健的 10 名 GP 招募了 5 到 10 名服用≥5 种常规药物的老年患者。GP 和患者都完成了一份关于患者使用膳食补充剂和对停止使用这些补充剂的态度的调查。我们描述并比较了他们的回答。我们使用多水平逻辑回归分析评估了补充剂披露与患者特征的关联。

结果

10 名 GP 中有 3 名(30%)是女性,GP 的平均年龄为 52 岁(标准差=8)。45%的患者为女性(29/65)。大多数患者(n=45,70%)正在服用≥1 种补充剂。患者平均报告使用三种补充剂(标准差=2)。在 60%(n=39)的患者中,GP 不知道患者使用的≥1 种补充剂。我们没有发现 GP 向患者披露补充剂与患者特征之间存在关联的证据。只有 8%(n=5)的患者和 60%(n=6)的 GP 报告了≥1 种他们愿意停止使用的补充剂,而 GP 和患者报告的要停止使用的补充剂没有一种匹配。

结论

瑞士的 GP 不知道他们的老年患者使用了许多膳食补充剂,这可能会影响药物优化工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a1b/11451169/2a17b2f8be7e/12875_2024_2605_Fig1_HTML.jpg

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