Rathore S S, Mehta S S, Boyko W L, Schulman K A
Clinical Economics Research Unit, Georgetown University Medical Center, Washington, DC, USA.
Fam Med. 1998 Nov-Dec;30(10):733-9.
Due to their high prevalence of disease, older Americans receive more prescription medication than any other age group. We evaluated prescription medication use in patients age 50 or older; categorized and reported medication use by age group, drug class, and therapeutic class; and examined differences in prescribing patterns for older patients.
All prescription medications reported in the 1995 National Ambulatory Medical Care Survey, a nationally representative sample of ambulatory care visits in the United States for patients age 50 and older (n = 16,289), were evaluated in a cross-sectional analysis. We evaluated the number of prescription medications reported for each patient visit and ranked use of drug and therapeutic classes.
Most patients seeing physicians (61%) had a prescription for at least one medication, ranging from a mean of 1.27 medications in patients ages 50-64 to 1.58 in patients over 85. Calcium channel blockers and angiotensin-converting enzyme inhibitors were prescribed more than beta blockers in all patients. Data also indicated a significant decrease in estrogen/progestin and antidepressant medication use in older patients.
Our findings indicate prescribing patterns inconsistent with national guidelines and decreased medication use, suggesting underprescription. Active intervention may be needed to improve the pharmacological treatment of older patients.
由于疾病患病率高，美国老年人比其他任何年龄组服用的处方药都更多。我们评估了50岁及以上患者的处方药使用情况；按年龄组、药物类别和治疗类别对药物使用进行分类和报告；并研究了老年患者处方模式的差异。
在一项横断面分析中，对1995年全国门诊医疗护理调查中报告的所有处方药进行了评估，该调查是美国50岁及以上患者门诊护理就诊情况的全国代表性样本（n = 16,289）。我们评估了每次患者就诊报告的处方药数量，并对药物和治疗类别的使用进行了排名。
大多数看医生的患者（61%）至少有一种药物的处方，50 - 64岁患者平均开具1.27种药物，85岁以上患者平均开具1.58种药物。在所有患者中，钙通道阻滞剂和血管紧张素转换酶抑制剂的处方量多于β受体阻滞剂。数据还表明老年患者雌激素/孕激素和抗抑郁药物的使用显著减少。
我们的研究结果表明处方模式与国家指南不一致且药物使用减少，提示处方不足。可能需要积极干预以改善老年患者的药物治疗。
