Lau Edward Chun Yin, Jeon Yun-Hee, Hilmer Sarah N, Tan Edwin C K
Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia.
Australas J Ageing. 2025 Mar;44(1):e13380. doi: 10.1111/ajag.13380. Epub 2024 Oct 27.
To identify the prevalence of and factors associated with medication use in people living with dementia in the community.
A cross-sectional study using baseline data from a randomised controlled trial known as the Interdisciplinary Home-bAsed Reablement Program (I-HARP) between 2018 and 2021 in Sydney, Australia. Participants included people with mild-moderate dementia and their carers. Medication use was classified according to the Anatomical Therapeutic Chemical codes, while potentially inappropriate medications (PIMs) were defined using 2019 Beer's Criteria and 2024 Australian list. Logistic regression models were used to identify factors associated with use of medication classes.
A total of 130 people with dementia and their carers were included. Of the people with dementia, 35% were using antidementia medication, 48% psychotropics, 76% PIMs and 65% polypharmacy (≥5 medications). Polypharmacy was associated with the use of psychotropics (adjusted OR [aOR]: 5.09, 95% confidence interval [CI]: 1.94-13.39) and PIMs (aOR: 17.38, 95% CI: 5.12-59.02). Higher education level was associated with lower odds of psychotropic use (aOR: .33, 95% CI: .15-.76), and age over 80 years was associated with lower odds of antidementia medication use (aOR: .29; 95% CI: .12-.72).
The use of PIMs, psychotropics and polypharmacy were common in this sample of people with dementia living in the community. Associations were seen between participant characteristics and medication use. Future research should focus on reviewing PIMs and polypharmacy in people with dementia living in the community to assess the impact on health outcomes.
确定社区中痴呆症患者的用药患病率及相关因素。
一项横断面研究，使用了2018年至2021年在澳大利亚悉尼进行的一项名为跨学科居家康复计划（I-HARP）的随机对照试验的基线数据。参与者包括轻度至中度痴呆症患者及其护理人员。药物使用根据解剖治疗化学代码进行分类，而潜在不适当药物（PIMs）则使用2019年《Beer标准》和2024年澳大利亚清单进行定义。使用逻辑回归模型来确定与药物类别使用相关的因素。
共纳入了130名痴呆症患者及其护理人员。在痴呆症患者中，35%使用抗痴呆药物，48%使用精神药物，76%使用PIMs，65%使用多种药物（≥5种药物）。使用多种药物与使用精神药物（调整后的比值比[aOR]：5.09，95%置信区间[CI]：1.94-13.39）和PIMs（aOR：17.38，95%CI：5.12-59.02）相关。较高的教育水平与使用精神药物的较低几率相关（aOR：0.33，95%CI：0.15-0.76），80岁以上的年龄与使用抗痴呆药物的较低几率相关（aOR：0.29；95%CI：0.12-0.72）。
在这个社区痴呆症患者样本中，PIMs、精神药物和多种药物的使用很常见。参与者特征与药物使用之间存在关联。未来的研究应侧重于审查社区痴呆症患者中的PIMs和多种药物使用情况，以评估对健康结果的影响。
