Prevalence of prescription and non-prescription polypharmacy by frailty and sex among middle-aged and older Canadians.

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Reports Pub Date : 2022-06-15 DOI:10.25318/82-003-x202200600001-eng

Daniel A Harris, Yanling Guo, Nardine Nakhla, Mina Tadrous, David B Hogan, Deirdre Hennessy, Kellie Langlois, Rochelle Garner, Sarah Leslie, Susan E Bronskill, George Heckman, Colleen J Maxwell

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引用次数: 3

Abstract

Background: Estimates of polypharmacy have primarily been derived from prescription claims, and less is known about the use of non-prescription medications (alone or in combination with prescription medications) across the frailty spectrum or by sex. Our objectives were to estimate the prevalence of polypharmacy (total, prescription, non-prescription, and concurrent prescription and non-prescription) overall, and by frailty, sex and broad age group.

Data: Canadian Health Measures Survey, Cycle 5, 2016 to 2017.

Methods: Among Canadians aged 40 to 79 years, all prescription and non-prescription medications used in the month prior to the survey were documented. Polypharmacy was defined as using five or more medications total (prescription and non-prescription), prescription only and non-prescription only. Concurrent prescription and non-prescription use was defined as two or more and three or more of each. Frailty was defined using a 31-item frailty index (FI) and categorized as non-frail (FI ≤ 0.1) and pre-frail or frail (FI > 0.1). Survey-weighted descriptive statistics were calculated overall and age standardized.

Results: We analyzed 2,039 respondents, representing 16,638,026 Canadians (mean age of 56.9 years; 51% women). Overall, 52.4% (95% confidence interval [CI] = 47.3 to 57.4) were defined as pre-frail or frail. Age-standardized estimates of total polypharmacy, prescription polypharmacy and concurrent prescription and non-prescription medication use were significantly higher among pre-frail or frail versus non-frail adults (e.g., total polypharmacy: 64.1% versus 31.8%, respectively). Polypharmacy with non-prescription medications was common overall (20.5% [95% CI = 16.1 to 25.8]) and greater among women, but did not differ significantly by frailty.

Interpretation: Polypharmacy and concurrent prescription and non-prescription medication use were common among Canadian adults, especially those who were pre-frail or frail. Our findings highlight the importance of considering non-prescribed medications when measuring the exposure to medications and the potential risk for adverse outcomes.

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加拿大中老年人群中按体弱多病和性别划分的处方和非处方多重用药的患病率。

背景:对多重用药的估计主要来自处方索赔，对跨体质谱或按性别使用非处方药(单独使用或与处方药联合使用)的了解较少。我们的目的是估计综合用药(总用药、处方用药、非处方用药、同时处方用药和非处方用药)的总体患病率，并按体质、性别和大年龄组划分。数据:加拿大健康措施调查，第5周期，2016年至2017年。方法:在40至79岁的加拿大人中，记录了调查前一个月使用的所有处方药和非处方药。多药被定义为总共使用五种或更多药物(处方和非处方)，仅使用处方和仅使用非处方。同时使用处方和非处方被定义为两种或两种以上，每种三种或三种以上。虚弱是用31项虚弱指数(FI)来定义的，并分为非虚弱(FI≤0.1)和预虚弱或虚弱(FI > 0.1)。调查加权描述性统计以总体和年龄标准化计算。结果:我们分析了2,039名受访者，代表16,638,026名加拿大人(平均年龄56.9岁;51%的女性)。总体而言，52.4%(95%置信区间[CI] = 47.3至57.4)被定义为体弱或体弱。在体弱多病或体弱多病的成年人中，总多药、处方多药以及同时使用处方药和非处方药的年龄标准化估计值明显高于非体弱多病的成年人(例如，总多药:分别为64.1%和31.8%)。非处方药的多重用药总体上很常见(20.5% [95% CI = 16.1至25.8])，在女性中更常见，但因体弱者而无显著差异。解释:在加拿大成年人中，多药和同时使用处方药和非处方药是很常见的，尤其是那些体弱或体弱的人。我们的研究结果强调了在测量药物暴露和潜在不良后果风险时考虑非处方药的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

4.00%

发文量

期刊介绍： Health Reports publishes original research on diverse topics related to understanding and improving the health of populations and the delivery of health care. We publish studies based on analyses of Canadian national/provincial representative surveys or Canadian national/provincial administrative databases, as well as results of international comparative health research. Health Reports encourages the sharing of methodological information among those engaged in the analysis of health surveys or administrative databases. Use of the most current data available is advised for all submissions.