Analgesic drug use in elderly persons: A population-based study in Southern Italy
Analgesic drug use in elderly persons: A population-based study in Southern Italy
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DOI：
10.1371/journal.pone.0222836
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发表时间：
2019-09-19
期刊：
影响因子：
3.7
通讯作者：
Trifiro', Gianluca
中科院分区：
文献类型：
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作者：
Ingrasciotta, Ylenia;Sultana, Janet;Trifiro', Gianluca
老年人常用的镇痛药有非甾体类抗炎药（NSAIDs）、弱阿片类和强阿片类。本研究的目的是描述老年镇痛药使用者的人口统计学和临床特征，并测量镇痛药的使用频率，包括潜在的不适当的镇痛药use.MethodsThe Arianna数据库的频率进行这项研究。该数据库包含在卡塞塔地方卫生单位（卡塞塔区，意大利坎帕尼亚地区）全科医生（GP）处注册的1，076，486名居民的处方数据和相关适应症。确定了2010年至2014年期间至少使用一种镇痛药物（NSAID，强效或弱效阿片类药物）的年龄> 1年的65岁人群。在研究期间的第一个止痛药处方的日期被认为是索引日期（ID）。ResultsFrom a source population of 1，076，486 people，116，486 elderly persons were identified.其中，94，820名老年人接受了至少一种镇痛药物：36.6%为NSAID使用者（N = 36，629），13.2%为弱阿片类药物使用者（N = 12，485），8.1%为强阿片类药物使用者（N = 7，658）。在不适当的镇痛剂使用方面，所有老年使用者中有9.2%（N = 10，763）被不适当地处方了酮咯酸/吲哚美辛，因为这些药物不应处方给老年人。此外，至少有一半的慢性肾脏疾病或充血性心力衰竭的老年人规定NSAIDs，而这些药物应避免. ConclusionAnalgics通常使用不当的老年人，这表明在集水区的处方实践可能还有待改善。
IntroductionAnalgesics such as non-steroidal anti-inflammatory drugs (NSAIDs), weak and strong opioids are commonly used among elderly persons. The aim of this study was to describe the demographic and clinical characteristics of elderly analgesic users and to measure the frequency of analgesic use, including the frequency of potentially inappropriate analgesic use.MethodsThe Arianna database was used to carry out this study. This database contains prescription data with associated indication of use for 1,076,486 inhabitants registered with their general practitioners (GPs) in the Caserta Local Health Unit (Caserta district, Campania region in Italy). A cohort of persons aged.65 years old with > 1 year of database history having at least one analgesic drug (NSAIDs, strong or weak opioids) between 2010 and 2014 were identified. The date of the first analgesic prescription in the study period was considered the index date (ID).ResultsFrom a source population of 1,076,486 persons, 116,486 elderly persons were identified. Of these, 94,820 elderly persons received at least one analgesic drug: 36.6% were incident NSAID users (N = 36,629), while 13.2% were incident weak opioid users (N = 12,485) and 8.1% were incident strong opioid users (N = 7,658). In terms of inappropriate analgesic use, 9.2% (N = 10,763) of all elderly users were prescribed ketorolac/indomethacin inappropriately, since these drugs should not be prescribed to elderly persons. Furthermore, at least half all elderly persons with chronic kidney disease or congestive heart failure were prescribed NSAIDs, while these drugs should be avoided.ConclusionAnalgesics are commonly used inappropriately among elderly persons, suggesting that prescribing practice in the catchment area may yet be improved.