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英国伦敦西北部针对基层医疗中服用多种药物患者的结构化药物评估:一项横断面研究

Structured medication reviews for patients with polypharmacy in primary care: a cross-sectional study in North West London, UK.

作者信息

Li Linwei, Greenfield Geva, Hayhoe Benedict W J, Lovett Derryn, Novov Vesselin, Majeed Azeem, Aylin Paul, Zaman Hadar, Woodcock Thomas

机构信息

Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W12 0BZ, UK.

School of Pharmacy and Medical Sciences, Faculty of Life Sciences, University of Bradford, Bradford, UK.

出版信息

JRSM Open. 2025 Apr 1;16(4):20542704251325056. doi: 10.1177/20542704251325056. eCollection 2025 Apr.

Abstract

OBJECTIVES

To identify the number and characteristics of patients with polypharmacy receiving structured medication reviews (SMRs) and medication reviews in primary care in 2022, and to evaluate whether the provision of these services is equitable across different demographic and socio-economic groups.

DESIGN

Cross-sectional study.

SETTING

Primary care networks in North West London, UK.

PARTICIPANTS

Adults registered with a general practitioner (GP) and regularly prescribed at least five medicines or more.

MAIN OUTCOME MEASURES

Receipt of at least one SMR and any kind of medication review during the study period (2022).

RESULTS

Among 515,042 adults regularly prescribed with medication, 167,482 were regularly prescribed at least five medicines, defined as polypharmacy. 53.3% (89,220) of these patients received at least one kind of medication review and 17.2% (11,954) of them received SMRs. Patients who were males, black, more affluent, and frailer, were more likely to receive medication reviews, while those who were males, less affluent, and frailer, were more likely to receive SMRs.

CONCLUSIONS

Although polypharmacy was common in North West London, only about half of eligible patients received medication reviews, and only 17.2% received SMRs. Different distributions of medication reviews and SMRs by demographic and socio-economic characteristics may indicate inequities in the provision of these services. Policy makers should consider effective ways to incentivise the equitable provision of SMRs.

摘要

目的

确定2022年在初级医疗保健中接受结构化药物审查(SMR)和药物审查的多重用药患者的数量及特征,并评估这些服务的提供在不同人口和社会经济群体中是否公平。

设计

横断面研究。

地点

英国伦敦西北部的初级医疗保健网络。

参与者

在全科医生(GP)处注册且经常服用至少五种或更多药物的成年人。

主要观察指标

在研究期间(2022年)接受至少一次SMR和任何类型药物审查的情况。

结果

在515,042名经常服用药物的成年人中,有167,482人经常服用至少五种药物,即多重用药。这些患者中有53.3%(89,220人)接受了至少一种药物审查,其中17.2%(11,954人)接受了SMR。男性、黑人、较富裕和身体较虚弱的患者更有可能接受药物审查,而男性、较不富裕和身体较虚弱的患者更有可能接受SMR。

结论

尽管多重用药在伦敦西北部很常见,但只有约一半的符合条件的患者接受了药物审查,只有17.2%的患者接受了SMR。药物审查和SMR在人口和社会经济特征方面的不同分布可能表明这些服务的提供存在不公平现象。政策制定者应考虑采取有效措施,激励公平提供SMR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e6b/11963712/7947511443e8/10.1177_20542704251325056-fig1.jpg

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