Are there sex differences in potentially inappropriate prescribing in adults with multimorbidity?
Are there sex differences in potentially inappropriate prescribing in adults with multimorbidity?
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DOI：
10.1111/jgs.17194
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发表时间：
2021-08
影响因子：
6.3
通讯作者：
Quiñones AR
中科院分区：
文献类型：
--
作者：
Ukhanova M;Markwardt S;Furuno JP;Davis L;Noble BN;Quiñones AR
有限的知识存在的性别差异，在处方潜在的不适当的药物（PIM）为各种多发病模式。本研究旨在确定老年人心血管代谢模式的PIM处方的性别差异。回顾性队列研究。健康和退休研究（HRS）2004-2014年访谈数据，与2005-2014年的HRS-Medicare索赔数据相关联。6，341名健康与退休研究（HRS）参与者≥65岁，患有两种及以上慢性疾病。PIM事件使用2015年美国老年病学会Beers标准计算。多模态模式包括：“仅心血管代谢”、“心血管代谢加其他身体状况”、“心血管代谢加精神状况”和“无心血管代谢疾病”模式。逻辑回归模型用于确定PIM和性别之间的关联，包括模型中性别和多药类别之间的相互作用，用于PIM整体和每个PIM药物类别。女性比男性更经常使用PIM（39.4% vs 32.8%）。总体而言，女性PIM的几率增加（OR = 1.30，95% CI：1.16-1.46）。在心血管-代谢和身体模式上，女性患PIM的几率高于男性（调整OR=1.25，95% CI：1.07-1.45）和心血管-代谢加心理模式（调整OR=1.25，95%CI：1.06-1.48），仅心血管代谢模式的成人无性别差异（调整OR=1.13，95% CI：0.79-1.62）。与男性相比，女性被处方以下PIM的几率更大：抗胆碱能药、抗抑郁药、解痉药、苯二氮卓类药物、骨骼肌松弛剂，并且被处方止痛药和磺脲类药物的几率更低。本研究评估了患有复杂心血管代谢多模式的成人中PIM处方的性别差异。性别的影响在多发病模式和不同的PIM药物类别中各不相同。这项研究确定了未来干预措施的重要机会，以改善有PIM风险的老年人的药物处方。
Limited knowledge exists regarding sex differences in prescribing potentially inappropriate medications (PIM) for various multimorbidity patterns. This study sought to determine sex differences in PIM prescribing in older adults with cardiovascular-metabolic patterns. Retrospective cohort study. Health and Retirement Study (HRS) 2004-2014 interview data, linked to HRS-Medicare claims data annualized for 2005-2014. 6,341 Health and Retirement Study (HRS) participants ≥65 y/o with two and more chronic conditions. PIM events were calculated using 2015 American Geriatrics Society Beers Criteria. Multimorbidity patterns included: ‘cardiovascular-metabolic only’, ‘cardiovascular-metabolic plus other physical conditions’, ‘cardiovascular-metabolic plus mental conditions’, and ‘no cardiovascular-metabolic disease’ patterns. Logistic regression models were used to determine the association between PIM and sex, including interaction between sex and multimorbidity categories in the model, for PIM overall and for each PIM drug class. Women were prescribed PIMs more often than men (39.4% vs 32.8%). Overall, women had increased odds of PIM (Adj. OR = 1.30, 95% CI: 1.16–1.46). Women had higher odds of PIM than men with cardiovascular-metabolic plus physical patterns (Adj.OR=1.25, 95% CI: 1.07-1.45) and cardiovascular-metabolic plus mental patterns (Adj.OR=1.25, 95% CI: 1.06-1.48), and there were no sex differences in adults with a cardiovascular-metabolic only patterns (Adj.OR=1.13, 95% CI: 0.79-1.62). Women had greater odds of being prescribed the following PIMs: anticholinergics, antidepressants, antispasmodics, benzodiazepines, skeletal muscle relaxants, and had lower odds of being prescribed pain drugs and sulfonylureas compared to men. This study evaluated sex differences in PIM prescribing among adults with complex cardiovascular-metabolic multimorbidity patterns. The effect of sex varied across multimorbidity patterns and by different PIM drug classes. This study identified important opportunities for future interventions to improve medication prescribing among older adults at risk for PIM.
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影响因子：
6.3
作者：
Jirón M;Pate V;Hanson LC;Lund JL;Jonsson Funk M;Stürmer T
通讯作者：
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影响因子：
3.3
作者：
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作者：
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通讯作者：
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