老年患者处方的纵向趋势：相隔四年的两项调查。
Longitudinal trends in prescribing for elderly patients: two surveys four years apart.
作者信息
Rumble R H, Morgan K
机构信息
Department of Health Care of the Elderly, University of Nottingham Medical School.
出版信息
Br J Gen Pract. 1994 Dec;44(389):571-5.
BACKGROUND
Elderly people are prescribed more drugs than younger people. The consequences of excessive or unwise prescribing, such as drug interactions, are well known.
AIM
A longitudinal study was undertaken to examine levels and patterns of prescribed drug use among a group of elderly people.
METHOD
Use of prescribed drugs by a sample of elderly people in Nottingham aged 65 years and over was assessed on two occasions four years apart, in 1985 and 1989.
RESULTS
Complete drug data were available for 1003 respondents in 1985 and 662 respondents in 1989 (with attrition due mainly to mortality). Drug use increased significantly with age. Women took significantly more drugs than men. Approximately half of respondents were taking at least two drugs. The overall number of drugs per person being taken in 1989 was significantly greater than in 1985. This difference remained significant when age and mortality were controlled, suggesting that changes in drug use over time within this sample may reflect genuine changes in prescribing practice (rather than simply the effects of ageing). The most commonly prescribed drug classes on each occasion were drugs for the cardiovascular system, central nervous system, musculoskeletal system, gastrointestinal tract and respiratory system. The subgroups of drugs most commonly reported at each interview were diuretics, hypnotics and anxiolytics, analgesics and non-steroidal anti-inflammatory drugs. Drugs within the category 'hypnotics and anxiolytics' showed clear and differential trends over time, with the use of anxiolytics falling, while the use of hypnotics increased. Among those respondents admitted to residential care during the course of the study higher levels of psychotropic drug use, and an increase in antipsychotic medication, were observed.
CONCLUSION
It is important that the drug regimens of elderly people are frequently reviewed to ensure that only the minimum number of effective drugs, in the simplest regimen, are prescribed.
背景
老年人比年轻人服用的药物更多。过度或不合理用药的后果，如药物相互作用，是众所周知的。
目的
进行一项纵向研究，以调查一组老年人的处方药使用水平和模式。
方法
1985年和1989年，对诺丁汉65岁及以上的一组老年人样本进行了两次评估，两次评估相隔四年，以评估他们对处方药的使用情况。
结果
1985年有1003名受访者可获得完整的药物数据，1989年有662名受访者可获得完整数据（损耗主要是由于死亡）。药物使用量随年龄显著增加。女性服用的药物明显多于男性。大约一半的受访者至少服用两种药物。1989年人均服用的药物总数明显多于1985年。在控制了年龄和死亡率后，这种差异仍然显著，这表明该样本中药物使用随时间的变化可能反映了处方实践的真正变化（而不仅仅是衰老的影响）。每次最常开具的药物类别是心血管系统、中枢神经系统、肌肉骨骼系统、胃肠道和呼吸系统药物。每次访谈中最常报告的药物亚组是利尿剂、催眠药和抗焦虑药、镇痛药和非甾体抗炎药。“催眠药和抗焦虑药”类别中的药物随时间呈现出明显的差异趋势，抗焦虑药的使用减少，而催眠药的使用增加。在研究过程中入住养老院的受访者中，观察到精神药物的使用水平较高，且抗精神病药物的使用有所增加。
结论
经常审查老年人的药物治疗方案非常重要，以确保仅开具最少数量的有效药物，采用最简单的治疗方案。
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