Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011.
Changes in Prescription and Over-the-Counter Medication and Dietary Supplement Use Among Older Adults in the United States, 2005 vs 2011.
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DOI：
10.1001/jamainternmed.2015.8581
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发表时间：
2016-04
影响因子：
39
通讯作者：
Alexander, G. Caleb
中科院分区：
文献类型：
--
作者：
Qato, Dima M.;Wilder, Jocelyn;Schumm, Philip;Gillet, Victoria;Alexander, G. Caleb
在老年人中，处方药和非处方药以及膳食补充剂通常单独或一起使用。然而，最近的监管和市场力量对这些模式的影响尚不清楚。描述药物使用流行程度的变化特征，包括同时使用处方药和非处方药以及膳食补充剂，并量化潜在主要药物-药物相互作用的频率和类型。描述性分析的纵向，全国代表性样本的社区居住的老年人62至85岁。2005-2006年和2010-2011年分别进行了直接药物检查的上门访谈。分析日期为2015年3月至11月。我们将药物使用定义为每天或每周至少使用一种处方药或非处方药或膳食补充剂同时使用定义为定期使用至少两种药物。我们使用Micromedex识别潜在的主要药物-药物相互作用。药物使用的流行程度（总体和按治疗类别）、同时使用和主要药物-药物相互作用的人口估计。研究队列包括2005-2006年的2351名参与者和2010-2011年的2206名参与者。2005-2006年的平均年龄为70.9岁，2010-2011年为71.4岁。2005-2006年的参与者中有53%是女性，2010-2011年的参与者中有51.6%是女性。至少使用一种处方药的比例由2005-2006年的84.1%上升至2010-2011年的87.7% （P = 0.003）。同时使用至少5种处方药的比例从30.6%上升至35.8% （P = 0.02）。非处方药的使用率从44.4%下降到37.9%，而膳食补充剂的使用率从51.8%上升到63.7%（两者的P < 0.001）。他汀类药物（33.8%至46.2%）、抗血小板药物（32.8%至43.0%）和omega-3鱼油（4.7%至18.6%）的使用均有显著增加（P < 0.05）。2010-2011年，大约15.1%的老年人存在潜在的主要药物相互作用风险，而2005-2006年估计为8.4% （P < 0.001）。大多数这些相互作用的方案涉及药物和膳食补充剂，在2010-2011年越来越多地使用。在这项研究中，自2005年以来，处方药和膳食补充剂的使用以及同时使用相互作用药物的情况有所增加，15%的老年人可能存在主要药物-药物相互作用的风险。通过使用多种药物提高安全性有可能减少与老年人常用药物相关的可预防的药物不良事件。
Prescription and over-the-counter medicines and dietary supplements are commonly used, alone and together, among older adults. However, the effect of recent regulatory and market forces on these patterns is not known. To characterize changes in the prevalence of medication use, including concurrent use of prescription and over-the-counter medications and dietary supplements, and to quantify the frequency and types of potential major drug-drug interactions. Descriptive analyses of a longitudinal, nationally representative sample of community-dwelling older adults 62 to 85 years old. In-home interviews with direct medication inspection were conducted in 2005–2006 and again in 2010–2011. The dates of the analysis were March to November 2015. We defined medication use as the use of at least 1 prescription or over-the-counter medication or dietary supplement at least daily or weekly and defined concurrent use as the regular use of at least 2 medications. We used Micromedex to identify potential major drug-drug interactions. Population estimates of the prevalence of medication use (in aggregate and by therapeutic class), concurrent use, and major drug-drug interactions. The study cohort comprised 2351 participants in 2005–2006 and 2206 in 2010–2011. Their mean age was 70.9 years in 2005–2006 and 71.4 years in 2010–2011. Fifty-three percent of participants were female in 2005–2006, and 51.6% were female in 2010–2011. The use of at least 1 prescription medication slightly increased from 84.1% in 2005–2006 to 87.7% in 2010–2011 (P = .003). Concurrent use of at least 5 prescription medications increased from 30.6% to 35.8% (P = .02). While the use of over-the-counter medications declined from 44.4% to 37.9%, the use of dietary supplements increased from 51.8% to 63.7%(P < .001 for both). There were clinically significant increases in the use of statins (33.8% to 46.2%), antiplatelets (32.8% to 43.0%), and omega-3 fish oils (4.7% to 18.6%) (P < .05 for all). In 2010–2011, approximately 15.1% of older adults were at risk for a potential major drug-drug interaction compared with an estimated 8.4% in 2005–2006 (P < .001). Most of these interacting regimens involved medications and dietary supplements increasingly used in 2010–2011. In this study, the use of prescription medications and dietary supplements, and concurrent use of interacting medications, has increased since 2005, with 15% of older adults potentially at risk for a major drug-drug interaction. Improving safety with the use of multiple medications has the potential to reduce preventable adverse drug events associated with medications commonly used among older adults.
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影响因子：
39.2
作者：
Lamberts, Morten;Lip, Gregory Y. H.;Gislason, Gunnar H.
通讯作者：
Gislason, Gunnar H.
DOI：
10.1001/jama.2015.13766
发表时间：
2015-11-03
期刊：
JAMA
影响因子：
--
作者：
Kantor ED;Rehm CD;Haas JS;Chan AT;Giovannucci EL
通讯作者：
Giovannucci EL
影响因子：
16.2
作者：
通讯作者：
--
影响因子：
158.5
作者：
Budnitz, Daniel S.;Lovegrove, Maribeth C.;Richards, Chesley L.
通讯作者：
Richards, Chesley L.
影响因子：
3
作者：
Briesacher, Becky A.;Zhao, Yanfang;Soumerai, Stephen B.
通讯作者：
Soumerai, Stephen B.