Polypharmacy among people with rheumatoid arthritis: The role of age, disease duration and comorbidity
Polypharmacy among people with rheumatoid arthritis: The role of age, disease duration and comorbidity
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DOI：
10.1002/msc.112
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发表时间：
2007-12-01
影响因子：
1.3
通讯作者：
Kitas, G. D.
中科院分区：
文献类型：
--
作者：
Treharne, G. J.;Douglas, K. M. J.;Kitas, G. D.
背景：类风湿性关节炎（RA）患者常合并有残疾和复杂的药物治疗方案。关于RA患者为什么需要如此多的药物治疗，几乎没有发表的证据，尽管这可能与年龄较大，RA持续时间较长，RA活动性更强，功能障碍更差和合并症数量更多有关。目的：我们开始量化RA的多种药物治疗，并在观察性队列中确定其预测因子。方法：对348例接受二级护理的RA患者的病例记录进行了审查，以记录多药治疗。计算28关节疾病活动度评分（DAS 28），并完成健康评估问卷（HAQ）和自我管理的合并症问卷（SCQ）。结果：平均总用药次数为5.39，最多16次，其中平均2.41次直接用于RA。一个中介关系被确定：年龄较大和较长的RA持续时间是更大的药物治疗总数的显着预测因子，但这些关系被解释为老年参与者和RA持续时间较长的合并症的数量较多。多药不相关的RA活动或功能disability.Conclusions：多药是常见的人与RA和关联年龄较大，RA持续时间较长，通过大量的合并症。主张由药剂师和其他专门从事风湿病学的卫生专业人员定期审查RA患者的完整治疗计划，以权衡每种药物的获益和风险及其相互作用，以了解RA活动和合并症。版权所有（C）2007约翰威利父子有限公司
Background: People with rheumatoid arthritis (RA) often have comorbidities with associated disability and complex medication regimens. Little published evidence exists about why people with RA require so many medications, although it is logical to hypothesize that this may relate to older age, longer duration of RA, more active RA, worse functional disability and a greater number of comorbidities.Objectives: We set out to quantify polypharmacy in RA and identify its predictors in an observational cohort.Methods: The case notes of 348 people receiving secondary care for RA were reviewed to record polypharmacy. The 28-joint Disease Activity Score (DAS28) was calculated and the Health Assessment Questionnaire (HAQ) and the Self-administered Comorbidity Questionnaire (SCQ) were completed.Results: The mean total number of medications was 5.39, with a maximum of 16; of these, a mean of 2.41 medications were directly for RA. A mediational relationship was identified: older age and longer RA duration were significant predictors of a greater total number of medications, but these relationships were explained by the greater number of comorbidities in older participants and those with longer RA duration. Polypharmacy was not related to RA activity or functional disability.Conclusions: Polypharmacy is common among people with RA and associates with older age and longer RA duration through a greater number of comorbidities. Regular review of the full treatment plan of individuals with RA by pharmacists and other health professionals specializing in rheumatology, to weigh the benefits and risks of each medication and their interactions in light of RA activity and comorbidities, is advocated. Copyright (C) 2007 John Wiley & Sons, Ltd.