Simões Pedro Augusto, Santiago Luiz Miguel, Simões José Augusto
Faculty of Health Sciences, University of Beira Interior; ARS Centro, USF Pulsar, Portugal.
Faculty of Medicine, University of Coimbra; CEISUC - Centre for Health Studies and Research of the University of Coimbra, Portugal.
Arch Med Sci. 2020 Mar 9;20(4):1118-1127. doi: 10.5114/aoms.2020.93537. eCollection 2024.
Polypharmacy is commonly defined as the simultaneous use of five or more medications; however, there is a lack of consensus regarding the most appropriate definition. It is a significant predictor of morbidity and mortality. The aim of this study was to determine the prevalence of polypharmacy in the population of older adults attending primary care in Portugal and to identify associated sociodemographic and clinical factors.
We conducted a cross-sectional, analytical study in primary care centres from the five Portuguese healthcare administrative regions and the two autonomous regions. We used a random sample of 757 older adult patients provided by the information department of the ministry of health (SPMS) and family doctors from the autonomous regions. Data collection occurred in March 2018. The variables utilised were sociodemographic characteristics, clinical profile and medication. For each patient, polypharmacy was measured either by the concurrent use of ≥ 5 drugs or by the median number of drugs at the time of data collection. Logistic regression analyses were performed to determine associations between polypharmacy and other variables.
Polypharmacy (≥ 5 drugs) was present in 77% of the sample. A cut-off of over the median number of drugs was present in 55%. The likelihood of having polypharmacy increased significantly with age (OR = 1.05 (1.02-1.08)), number of chronic health problems (OR = 1.24 (1.07-1.45)) and number of prescribers (OR = 4.71 (3.42-6.48)). Cardiovascular, metabolic and musculoskeletal medications were the most commonly involved in polypharmacy.
Polypharmacy was a very common occurrence in Portugal. Future primary healthcare policies should address polypharmacy.
多重用药通常被定义为同时使用五种或更多药物；然而，对于最合适的定义尚无共识。它是发病率和死亡率的重要预测指标。本研究的目的是确定葡萄牙接受初级保健的老年人群中多重用药的患病率，并确定相关的社会人口统计学和临床因素。
我们在葡萄牙五个医疗保健行政区和两个自治区的初级保健中心进行了一项横断面分析研究。我们使用了由卫生部信息部门（SPMS）和自治区家庭医生提供的757名老年患者的随机样本。数据收集于2018年3月进行。所使用的变量包括社会人口统计学特征、临床概况和用药情况。对于每位患者，多重用药通过同时使用≥5种药物或数据收集时的药物中位数来衡量。进行逻辑回归分析以确定多重用药与其他变量之间的关联。
77%的样本存在多重用药（≥5种药物）。超过药物中位数的临界值存在于55%的样本中。多重用药的可能性随着年龄（OR = 1.05（1.02 - 1.08））、慢性健康问题数量（OR = 1.24（1.07 - 1.45））和开处方者数量（OR = 4.71（3.42 - 6.48））的增加而显著增加。心血管、代谢和肌肉骨骼药物是多重用药中最常涉及的药物。
多重用药在葡萄牙非常普遍。未来的初级医疗保健政策应解决多重用药问题。
