Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia
Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia
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DOI：
10.1371/journal.pone.0173466
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发表时间：
2017-03-08
期刊：
影响因子：
3.7
通讯作者：
Rajasuriar, Reena
中科院分区：
文献类型：
--
作者：
Lim, Li Min;McStea, Megan;Rajasuriar, Reena
BackgroundPolypharmacy已与老年population.ObjectivesThe的发病率和死亡率的增加，本研究的目的是确定的患病率，风险因素和健康结果与多药治疗在城市社区居住的老年人接受慢性药物治疗在Malaysia.MethodsThis队列是一个基线研究在马来西亚老年人纵向研究队列。入选标准为年龄≥ 55岁且长期服用至少一种药物（≥ 3个月）的个体。在家访期间，使用结构化问卷对参与者进行了访谈，并对所服用的药物进行了审查。评估的健康结局包括福尔斯频率、功能障碍、潜在的不适当药物使用（PIM）、潜在的药物相互作用（PDDI）、医疗保健利用和生活质量（QoL）。与多药（>= 5药物，包括膳食补充剂）相关的风险因素和健康结果进行了测定，使用多变量回归models.ResultsA共1256名参与者被纳入与中位数（四分位数范围）年龄为69（63-74）岁。多种药物的患病率为45.9%，而补充剂使用者占队列的56.9%。与药物使用增加相关的风险因素包括年龄增加、印度种族、男性、合并症数量增加，特别是诊断为心血管、内分泌和胃肠道疾病的合并症，以及补充剂的使用。与多药治疗显著相关的健康结果是PIMS，PDDIs和增加的医疗保健utilisation.ConclusionA的老年人的慢性药物治疗的显着比例暴露于多药治疗和使用膳食补充剂的贡献显着。药物审查是必要的，以减少显着的多药相关的问题，在老年人口。
BackgroundPolypharmacy has been associated with increased morbidity and mortality in the older population.ObjectivesThe aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia.MethodsThis was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged >= 55years and taking at least one medication chronically (>= 3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drugdrug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (>= 5 medications including dietary supplements) were determined using multivariate regression models.ResultsA total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation.ConclusionA significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.