Klaukka T, Mäkelä M, Sipilä J, Martikainen J
Social Insurance Institution, Helsinki, Finland.
Med Care. 1993 May;31(5):445-50. doi: 10.1097/00005650-199305000-00006.
The purpose of this study was to investigate the occurrence of multiuse of prescription drugs and its major determinants among Finnish adults. The data were based on three nationally representative and intercomparable health surveys in 1976, 1978-80, and 1987. The study populations were 16,413 in 1976, 13,138 in 1987, and 7,217 in 1978-80. The simultaneous use of at least five prescription drugs was the main outcome measure. In 1976, 4.7% of the study population, and 6.3% in 1987 were multiusers. Of all users of prescription drugs, the proportion of multiusers was 14% both in 1976 and 1987. In 1987, the elderly comprised 55% of all multiusers, whereas their share in 1976 was 44%. The strongest predictor of the multiuse was, as expected, chronic morbidity. Of the various diagnostic groups, the main determinants were cardiac insufficiency, hypertension, asthma, mental disorders, and coronary heart disease. Even allowing for chronic morbidity, age was significantly associated with multiuse, but sex was not. The number of visits to a primary care physician correlated also independently with the multiuse. These findings indicate that the elderly may in part get prescriptions indiscriminately.
本研究旨在调查芬兰成年人中处方药多药联用的情况及其主要决定因素。数据基于1976年、1978 - 1980年以及1987年三项具有全国代表性且可相互比较的健康调查。1976年的研究人群有16413人，1987年有13138人，1978 - 1980年有7217人。主要的结局指标是同时使用至少五种处方药。1976年，4.7%的研究人群为多药联用者，1987年这一比例为6.3%。在所有处方药使用者中，1976年和1987年多药联用者的比例均为14%。1987年，老年人占所有多药联用者的55%，而1976年他们的占比为44%。正如预期的那样，多药联用的最强预测因素是慢性病发病率。在各个诊断组中，主要决定因素是心功能不全、高血压、哮喘、精神障碍和冠心病。即使考虑到慢性病发病率，年龄与多药联用也显著相关，但性别则不然。到初级保健医生处就诊的次数也与多药联用独立相关。这些发现表明，老年人可能在一定程度上会不加区分地获取处方。
