沙特阿拉伯老年人潜在不适当用药的轨迹。

Trajectories of potentially inappropriate medication use among older adults in Saudi Arabia.

作者信息

Jabri Fouad F, Liang Yajun, Johnell Kristina, Möller Jette

机构信息

Department of Biostatistics, Epidemiology and Public Health, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Front Pharmacol. 2025 Apr 29;16:1568160. doi: 10.3389/fphar.2025.1568160. eCollection 2025.

DOI:10.3389/fphar.2025.1568160

PMID:40365312

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12069998/

Abstract

BACKGROUND

The trajectories of potentially inappropriate medications (PIMs) among older adults have not been well studied. This study aims to determine the 3-year trajectories of PIM dispensation and their determinants in older adults in Saudi Arabia.

METHODS

A cohort study was carried out based on medical records from visits by 9,887 older adults (≥65 years) to outpatient clinics at King Saud University Medical City in Saudi Arabia from 2017 to 2019. PIMs were identified using the 2019 Beers Criteria, using the first category: medications that should be avoided by most older adults. Multinomial logistic regression was used to estimate the associations between clinical factors and the trajectories of PIM adjusting for sociodemographic factors.

RESULTS

The analysis showed that over 82% dispensed at least one PIM, with 55.9% having sustained PIMs, 17.9% having no PIMs, 14.0% starting PIMs, and 12.2% experiencing sporadic PIM dispensations. After adjustment, metabolic disorders (adjusted odds ratio [aOR]: 2.61, 95% confidence interval [95% CI]: 2.17-3.15), hypertensive diseases (aOR: 5.32, 95% CI: 4.67-6.07), diabetes mellitus (aOR: 10.22, 95% CI: 8.80-11.86), and diseases of the esophagus, stomach, or duodenum (aOR: 10.90, 95% CI: 7.39-16.09) were significantly associated with sustained PIM dispensation. With an increasing number of diagnoses we found an increasing odds for three trajectories (starting PIM (aOR range 1.56 to 5.82), sporadic PIM (aOR range 1.47 to 4.86), and sustained PIM (aOR range 3.91 to 37.3). Furthermore, an increasing number of medications was associated with higher odds for the same trajectories: starting PIM (aOR range 2.01 to 6.03), sporadic PIM (aOR range 1.50 to 7.10), and sustained PIM (aOR range 4.34 to 59.9).

CONCLUSION

This study showed a high prevalence of sustained trajectories of PIMs over time. Further, several common diagnoses and a greater total number of medications were identified as being associated with different PIM trajectories.

摘要

背景

老年人中潜在不适当用药（PIMs）的轨迹尚未得到充分研究。本研究旨在确定沙特阿拉伯老年人中PIMs配药的3年轨迹及其决定因素。

方法

基于2017年至2019年沙特阿拉伯国王沙特大学医学城门诊9887名老年人（≥65岁）就诊的病历进行队列研究。使用2019年Beers标准识别PIMs，采用第一类：大多数老年人应避免使用的药物。使用多项逻辑回归来估计临床因素与调整社会人口学因素后的PIM轨迹之间的关联。

结果

分析显示，超过82%的人至少配药一种PIM，其中55.9%持续使用PIM，17.9%未使用PIM，14.0%开始使用PIM，12.2%偶尔配药使用PIM。调整后，代谢紊乱（调整优势比[aOR]：2.61，95%置信区间[95%CI]：2.17 - 3.15）、高血压疾病（aOR：5.32，95%CI：4.67 - 6.07）、糖尿病（aOR：10.22，95%CI：8.80 - 11.86）以及食管、胃或十二指肠疾病（aOR：10.90，95%CI：7.39 - 16.09）与持续使用PIM显著相关。随着诊断数量的增加，我们发现三种轨迹的可能性增加（开始使用PIM（aOR范围1.56至5.82）、偶尔使用PIM（aOR范围1.47至4.86）和持续使用PIM（aOR范围3.91至37.3））。此外，药物数量的增加与相同轨迹的更高可能性相关：开始使用PIM（aOR范围2.01至6.03）、偶尔使用PIM（aOR范围1.50至7.10）和持续使用PIM（aOR范围4.34至59.9）。