伊朗代谢综合征患者的多重用药和潜在不适当用药：流行病学特征及相关因素，一项全国性多层次横断面研究
Polypharmacy and Potentially Inappropriate Medication in Iranian People With Metabolic Syndrome: Epidemiological Aspects and Related Factors, a Multi-Level Cross-Sectional National Study.
作者信息
Daneshmand Mojdeh, Jamshidi Hamidreza, Malekpour Mohammad-Reza, Ghasemi Erfan, Moghaddam Sahar Saeedi, Mortazavi Seyede Salehe, Shati Mohsen, Farjoo Mohammad Hadi, Farzadfar Farshad
机构信息
Department of Pharmacology, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran.
出版信息
Health Sci Rep. 2025 Apr 9;8(4):e70600. doi: 10.1002/hsr2.70600. eCollection 2025 Apr.
BACKGROUND AND AIMS
Polypharmacy, characterized by the concurrent use of five or more medications in a prescription, potentially resulting in adverse outcomes, is frequently observed among individuals with metabolic syndrome, which encompasses a collection of conditions that co-occur, heightening the likelihood of heart disease, stroke, and type 2 diabetes. This study seeks to ascertain the prevalence of polypharmacy and the use of potentially inappropriate medications (PIMs) among Iranian patients with metabolic syndrome, while also evaluating the contributing individual and sociodemographic factors.
METHODS
This was a population-based, cross-sectional national study. Two databases were used: (a) Iranians Health Insurance Service database and (b) Iran's STEPS 2016 survey. Patients with metabolic syndrome conjoint in both databases were selected. Among these patients, polypharmacy and PIM were evaluated, and their association with individual and sociodemographic factors was assessed. Univariate and multivariate logistic regression were used to analyze the associations. All statistical analyses were done using SPSS 22 and Python 3.
RESULTS
Out of 2075 metabolic syndrome patients, 10.3% had polypharmacy. Polypharmacy significantly increased by age (OR: 4.334, adjusted for > 80-year-olds vs. 25-39-year-olds [CI: 1.664-11.283], < 0.001), and its prevalence was significantly higher in urban areas (OR: 2.326 [CI: 1.645-3.288], < 0.001). Polypharmacy was 5.88% in West, 5.41% in Southeast, 5.04% in Central, and 4.83% in North-Northeast of Iran. PIM was 13.2% in ≥ 60 years and significantly higher in urban areas (OR: 2.014 [CI: 1.153-3.519], < 0.001).
CONCLUSIONS
Since the area of residency affects polypharmacy and PIM more significantly than wealth status and education level, it is important to implement preventive measures in urban areas.
背景与目的
多重用药是指在一张处方中同时使用五种或更多药物，这可能会导致不良后果，在代谢综合征患者中经常出现。代谢综合征是一系列共同出现的病症，会增加患心脏病、中风和2型糖尿病的可能性。本研究旨在确定伊朗代谢综合征患者中多重用药和潜在不适当用药（PIMs）的患病率，同时评估相关的个体因素和社会人口学因素。
方法
这是一项基于人群的全国性横断面研究。使用了两个数据库：（a）伊朗健康保险服务数据库和（b）伊朗2016年的STEPS调查。选取了两个数据库中都存在的代谢综合征患者。在这些患者中，评估了多重用药和PIMs情况，并评估了它们与个体因素和社会人口学因素的关联。采用单因素和多因素逻辑回归分析这些关联。所有统计分析均使用SPSS 22和Python 3完成。
结果
在2075名代谢综合征患者中，10.3%患有多重用药。多重用药情况随年龄显著增加（比值比：4.334，针对80岁以上人群与25 - 39岁人群进行调整[可信区间：1.664 - 11.283]，P < 0.001），且在城市地区的患病率显著更高（比值比：2.326[可信区间：1.645 - 3.288]，P < 0.001）。伊朗西部的多重用药率为5.88%，东南部为5.41%，中部为5.04%，东北北部为4.83%。60岁及以上人群的PIMs率为13.2%，在城市地区显著更高（比值比：2.014[可信区间：1.153 - 3.519]，P < 0.001）。
结论
由于居住地区对多重用药和PIMs的影响比财富状况和教育水平更为显著，因此在城市地区实施预防措施很重要。
Zotero 插件