Prevalence of Polypharmacy, Polyherbacy, Nutritional Supplement Use and Potential Product Interactions among Older Adults Living on the United States-Mexico Border A Descriptive, Questionnaire-Based Study
Prevalence of Polypharmacy, Polyherbacy, Nutritional Supplement Use and Potential Product Interactions among Older Adults Living on the United States-Mexico Border A Descriptive, Questionnaire-Based Study
复制标题
DOI：
10.2165/00002512-200926050-00006
复制
发表时间：
2009-01-01
期刊：
影响因子：
2.8
通讯作者：
Rivera, Jose O.
中科院分区：
文献类型：
--
作者：
Loya, Amanda M.;Gonzalez-Stuart, Armando;Rivera, Jose O.
背景和目的：使用多种药物、草药或营养补充剂可能导致不良后果，特别是在老年人中。多药、多草和营养补充剂使用的一个重要后果是各种产品之间可能发生相互作用。本研究的主要目的是估计居住在美墨边境的老年人中多种药物、多种草药、营养补充剂使用和潜在产品相互作用的流行程度。方法：这是一项描述性研究，包括对2005年6月至2006年3月期间从人口最稠密的美墨边境地区的老年中心招募的年龄在60岁以上的成年人进行双语（英语/西班牙语）问卷调查。除了目前使用的处方药、非处方（OTC）药物、草药产品和营养补充剂（即营养品和维生素或矿物质）的信息外，还收集了参与者的人口统计数据。测量的结果是每个参与者服用处方药、非处方药、草药产品、维生素/矿物质和营养食品的数量。此外，确定了每个参与者的药物、草药产品和营养补充剂之间潜在相互作用和主要相互作用的数量。此外，还比较了男女之间以及边境地区各地点之间的产品使用模式。结果：共招募130名参与者（平均年龄71.4岁）完成问卷调查。在所有参与者中，多重用药的患病率为72.3% (n = 94)，其中38.5% （n = 50）同时服用五种及以上药物（主要多重用药）。在研究样本中，21名参与者（16.2%）报告服用两种或两种以上的草药产品（多草药）。34名参与者（26.2%）报告服用两种或两种以上维生素/矿物质补充剂，9名参与者（6.9%）报告使用两种或两种以上营养保健品。生活在边境美国一侧的参与者比生活在边境墨西哥一侧的参与者有更高的主要多种药物，多种草药和营养补充剂的使用率。总体而言，男性和女性在药物、草药产品和营养补充剂的使用模式上没有显著差异。对潜在相互作用的评估显示，46.2% （n = 60）的参与者存在至少一种潜在药物-药物相互作用的风险。关于药物和草药产品-补充剂的相互作用，31.5% （n = 41）的参与者存在至少一种可能相互作用的风险。结论：生活在美国边境的老年人中，多种药物的流行程度与全国趋势相似（估计表明，四分之一到一半的美国65岁以上的成年人服用五种或更多种药物）。然而，在生活在墨西哥边境一侧的老年人中，使用多种药物的情况不太常见。此外，居住在美墨边境的老年人使用草药的比例高于美国成年人的全国调查报告，这表明在过去的12个月内，不到四分之一的成年人使用过草药产品。此外，这项研究表明，生活在边境美国一侧的老年人比墨西哥同行消耗更多的草药和营养补充剂。除了描述边境地区的产品使用模式外，这些发现还表明，几乎一半的老年参与者有潜在的药物-药物相互作用的风险，大约三分之一的人在他们的药物、草药或营养补充剂之间有潜在的相互作用。
Background and objective: The use of multiple medications, herbs or nutritional supplements can lead to adverse consequences, particularly in the elderly. A significant consequence resulting from polypharmacy, polyherbacy and nutritional supplement use is the potential for interactions to occur among the various products. The primary objective of this study was to estimate the prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the US-Mexico border.Methods: This was a descriptive study that involved the administration of a bilingual (English/Spanish) questionnaire to a convenience sample of adults aged >= 60 years recruited from senior centres located within the most populated US-Mexico border region from June 2005 to March 2006. Participant demographics were collected in addition to information about current use of prescription medications, over-the-counter (OTC) medications, herbal products and nutritional supplements (i.e. nutraceuticals and vitamins or minerals). The outcomes measured were the number of prescription medications, OTC medications, herbal products, vitamins/minerals and nutraccuticals per participant. Furthermore, the number of potential interactions and major interactions between drugs, herbal products and nutritional supplements were identified for each participant. Additionally, product use patterns between men and women and among locations within the border region were compared.Results: One-hundred-and-thirty participants (mean age 71.4 years) were recruited to complete the questionnaire. The prevalence of polypharmacy among all participants was 72.3% (n = 94), with 38.5% (n = 50) taking five or more concomitant medications (major polypharmacy). Twenty-one participants (16.2%) in the study sample reported taking two or more herbal products (polyherbacy). Thirty-four participants (26.2%) reported taking two or more vitamin/mineral supplements and nine (6.9%) reported using two or more nutraceuticals. Participants living on the US side of the border had higher rates of major polypharmacy, polyherbacy and use of nutritional supplements than those living on the Mexican side of the border. Overall, there were no significant differences in medication, herbal product and nutritional supplement use patterns between men and women. Evaluation of potential interactions revealed that 46.2% (n = 60) of participants were at risk of having at least one potential drug-drug interaction. Regarding drug and herbal product-supplement interactions, 31.5% (n = 41) of participants were at risk of having at least one possible interaction.Conclusions: The prevalence of polypharmacy among older adults living on the US side of the border was similar to national trends (estimates suggest that one-quarter to one-half of US adults aged >= 65 years take five or more medications). However, polypharmacy was less common in older adults living on the Mexican side of the border. Additionally, herb use was higher in older adults living on the US-Mexico border than has been reported in national surveys of US adults, which indicate that less than one-quarter of adults have used a herbal product within the previous 12 months. Furthermore, this study demonstrated that older adults living on the US side of the border consumed more herbs and nutritional supplements than their Mexican counterparts. In addition to describing product use patterns on the border, these findings suggest that almost half of the older adult participants were at risk for a potential drug-drug interaction, with approximately one-third having a potential interaction between their medications, herbs or nutritional supplements.