Majewski Gabriel, Grodzka Olga, Walkowski Radosław, Kandefer Tomasz, Papciak Kinga, Słyk Stanisław, Domitrz Izabela
Department of Neurology, Medical University of Warsaw, Warsaw, POL.
Cureus. 2024 Oct 19;16(10):e71868. doi: 10.7759/cureus.71868. eCollection 2024 Oct.
Polypharmacy, a growing public health and economic concern, is particularly common among the elderly due to the high prevalence of multimorbidity, such as dementia and stroke, which necessitates complex treatment regimens. While commonly understood as taking five or more medications, definitions of polypharmacy are varied and may be misleading in clinical practice. This research examines factors such as a country's expenditure on health and education, age, and clinicians' holistic approaches to compare the prevalence of polypharmacy across different groups. The review included documentary research through PubMed, Scopus, and Google Scholar databases and search engines, resulting in seven selected sources. The average year of publication was 2020 (median: 2020; standard deviation: 1.63; range: 2018 to 2023). The level of polypharmacy was found to be significantly dependent on per capita expenditure on education (R = -0.79; F(6) = -3.11; p = 0.02) and health (R = -0.76; F(6) = -2.88; p = 0.03). Countries with higher spending in these areas had a lower proportion of participants with polypharmacy. Additionally, patients' quality of life (QoL) is closely tied to the amount of medication they consume, highlighting the need for physicians to avoid unnecessary prescriptions. Patients impacted by polypharmacy often lack knowledge about their diseases and medications, negatively affecting their QoL and compliance. To develop effective treatment plans and improve clinical practice, doctors should consider these risk factors, prioritize patient education, and utilize innovative technologies to support patients. While polypharmacy is sometimes unavoidable and necessary, this approach could in some cases help mitigate the challenges and risks posed by inappropriate polypharmacy and enhance patients' QoL. Furthermore, policymakers should consider increasing spending on education and healthcare, as this may resolve clinical and economic problems related to the issue.
多重用药是一个日益引起公共卫生和经济关注的问题，由于痴呆症和中风等多种疾病的高患病率，多重用药在老年人中尤为常见，这就需要复杂的治疗方案。虽然多重用药通常被理解为服用五种或更多药物，但多重用药的定义各不相同，在临床实践中可能会产生误导。本研究考察了一个国家在卫生和教育方面的支出、年龄以及临床医生的整体治疗方法等因素，以比较不同群体中多重用药的患病率。该综述包括通过PubMed、Scopus和谷歌学术数据库及搜索引擎进行的文献研究，最终选定了七篇文献。平均发表年份为2020年（中位数：2020年；标准差：1.63；范围：2018年至2023年）。研究发现，多重用药水平显著依赖于人均教育支出（R = -0.79；F(6) = -3.11；p = 0.02）和卫生支出（R = -0.76；F(6) = -2.88；p = 0.03）。在这些领域支出较高的国家，多重用药参与者的比例较低。此外，患者的生活质量（QoL）与他们服用的药物数量密切相关，这突出了医生避免不必要处方的必要性。受多重用药影响的患者往往对自己的疾病和药物缺乏了解，这对他们的生活质量和依从性产生负面影响。为了制定有效的治疗方案并改善临床实践，医生应考虑这些风险因素，优先开展患者教育，并利用创新技术来支持患者。虽然多重用药有时是不可避免且必要的，但这种方法在某些情况下有助于减轻不适当多重用药带来的挑战和风险，并提高患者的生活质量。此外，政策制定者应考虑增加教育和医疗保健支出，因为这可能解决与该问题相关的临床和经济问题。
