Korinihona Tania, Thompson Fintan, Russell Sarah Gillian, Quigley Rachel, Miller Gavin, Sagigi Betty, Strivens Edward
Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia.
Queensland Health, Metro North Health Service, Brisbane, Queensland, Australia.
Australas J Ageing. 2025 Mar;44(1):e13390. doi: 10.1111/ajag.13390. Epub 2024 Nov 10.
This study assessed the prevalence of suboptimal prescribing of medicines in First Nations older adults in the Torres Strait. Types of suboptimal prescribing included polypharmacy, over-prescribing, under-prescribing and anticholinergic burden. It also assessed any significant associations between suboptimal prescribing and common age-related problems such as falls, reduced function and cognition.
Cross-sectional study (2015-2018) on 18 island and five mainland communities in the Torres Strait and Northern Peninsula Area of Far North Queensland, Australia. Community-dwelling residents aged 45 years and older who identified as Torres Strait Islander and/or Aboriginal with complete medication histories were recruited in this study. Validated prescribing tools were used to identify suboptimal prescribing practises.
There were 254 participants with complete medication histories. The mean age was 65.7 (SD ± 10.9, range 45-93), with 65% female. Suboptimal prescribing in this study was 74%. Of these, 49% of participants had polypharmacy, 44% were over-prescribed, and 36% were under-prescribed. Anticholinergic burden was identified in 26% of participants. Polypharmacy was more prevalent in participants who were dependent on instrumental activities of daily living (iADLs).
The results demonstrate the importance of general practitioners, health-care workers or pharmacists, to monitor medication prescribing in this population. Frequent review of medications to reduce suboptimal prescribing practices within these communities may help to reduce adverse outcomes because of prescribing practices.
本研究评估了托雷斯海峡原住民老年人中药物处方不合理的患病率。处方不合理的类型包括多重用药、处方过量、处方不足和抗胆碱能负担。研究还评估了处方不合理与跌倒、功能减退和认知等常见年龄相关问题之间的显著关联。
对澳大利亚昆士兰州远北地区托雷斯海峡和北半岛地区的18个岛屿社区和5个大陆社区进行横断面研究（2015 - 2018年）。本研究招募了年龄在45岁及以上、自我认定为托雷斯海峡岛民和/或原住民且有完整用药史的社区居民。使用经过验证的处方工具来识别不合理的处方行为。
共有254名参与者有完整的用药史。平均年龄为65.7岁（标准差±10.9，范围45 - 93岁），其中65%为女性。本研究中处方不合理的比例为74%。其中，49%的参与者存在多重用药，44%处方过量，36%处方不足。26%的参与者存在抗胆碱能负担。多重用药在依赖日常生活工具性活动（iADL）的参与者中更为普遍。
结果表明，全科医生、医护人员或药剂师监测该人群的药物处方非常重要。定期审查药物以减少这些社区内的不合理处方行为，可能有助于减少因处方行为导致的不良后果。
