Overuse of medications in low- and middle-income countries: a scoping review.
Overuse of medications in low- and middle-income countries: a scoping review.
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DOI：
10.2471/blt.22.288293
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发表时间：
2023-01-01
影响因子：
11.1
通讯作者：
Moynihan, Ray
中科院分区：
文献类型：
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作者：
Albarqouni, Loai;Palagama, Sujeewa;Chai, Julia;Sivananthajothy, Priatharsini;Pathirana, Thanya;Bakhit, Mina;Arab-Zozani, Morteza;Ranakusuma, Respati;Cardona, Magnolia;Scott, Anna;Clark, Justin;Smith, Claire Friedemann;Effa, Emmanuel;Ochodo, Eleanor;Moynihan, Ray
确定和总结有关低收入和中等收入国家药物过度使用程度、其驱动因素、后果和潜在解决办法的证据。我们通过搜索PubMed®、Embase®、APA PsycINFO®和Global Index Medicus数据库，结合MeSH术语和关于过度使用药物和过度治疗的自由文本词，进行了范围审查。我们纳入了在2021年10月25日之前发表的任何语言的研究，这些研究报告了过度使用的程度、驱动因素、后果和解决方案。我们筛选了3489份独特记录，纳入了367项研究，报告了80个低收入和中等收入国家的510多万份处方，其中58.6%（17/29）的研究来自低收入国家，62.0%（31/50）的研究来自中低收入国家，60.0%（33/55）的研究来自中高收入国家。在纳入的研究中，307项（83.7%）报告了药物过度使用的程度，估计范围为7.3%至98.2%（四分位数间距：30.2-64.5）。常见的滥用药物包括抗菌素、精神药物、质子泵抑制剂和抗高血压药物。驱动因素包括对过度使用、多种药物、监管不力和金融影响的危害了解有限。结果是病人的伤害和成本。只有11.4%（42/367）的研究评估了解决方案，其中包括监管改革、教育、处方和审计反馈举措。越来越多的证据表明，药物过度使用在低收入和中等收入国家普遍存在，涉及多种药物类别，而来自随机试验的解决方案数据很少。有机会建立合作，以严格制定和评估减少药物过度使用的潜在解决方案。
To identify and summarize the evidence about the extent of overuse of medications in low- and middle-income countries, its drivers, consequences and potential solutions. We conducted a scoping review by searching the databases PubMed®, Embase®, APA PsycINFO® and Global Index Medicus using a combination of MeSH terms and free text words around overuse of medications and overtreatment. We included studies in any language published before 25 October 2021 that reported on the extent of overuse, its drivers, consequences and solutions. We screened 3489 unique records and included 367 studies reporting on over 5.1 million prescriptions across 80 low- and middle-income countries – with studies from 58.6% (17/29) of all low-, 62.0% (31/50) of all lower-middle- and 60.0% (33/55) of all upper-middle-income countries. Of the included studies, 307 (83.7%) reported on the extent of overuse of medications, with estimates ranging from 7.3% to 98.2% (interquartile range: 30.2–64.5). Commonly overused classes included antimicrobials, psychotropic drugs, proton pump inhibitors and antihypertensive drugs. Drivers included limited knowledge of harms of overuse, polypharmacy, poor regulation and financial influences. Consequences were patient harm and cost. Only 11.4% (42/367) of studies evaluated solutions, which included regulatory reforms, educational, deprescribing and audit–feedback initiatives. Growing evidence suggests overuse of medications is widespread within low- and middle-income countries, across multiple drug classes, with few data of solutions from randomized trials. Opportunities exist to build collaborations to rigorously develop and evaluate potential solutions to reduce overuse of medications.
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DOI：
10.4102/phcfm.v13i1.2889
发表时间：
2021-06-24
影响因子：
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作者：
Adedayo T;O'Mahony D;Adeleke O;Mabunda S
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影响因子：
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影响因子：
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作者：
Hoteit M;Mattar E;Allaw R;Abou Rached A
通讯作者：
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DOI：
10.11604/pamj.2020.37.94.22712
发表时间：
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期刊：
The Pan African medical journal
影响因子：
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DOI：
10.1177/0300060520987731
发表时间：
2021-03
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