慢性疾病和老年患者的综合用药:斯里兰卡北部一项基于医院的研究

S. N. Thiyahiny, T. Kumanan, R. Surenthirakumaran
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摘要

人口老龄化和老年人的多重病理增加了老年人的药物使用。本研究的目的是评估贾夫纳教学医院住院老年人的慢性疾病和多重用药,并确定与多重用药相关的因素。这是一项横断面描述性研究。老年人和多药患者分别定义为≥65岁,同时使用≥6种药物≥1个月。采用数据提取表对288例老年患者的住院病历进行数据采集。采用卡方检验和配对t检验来确定显著性水平,计算未调整奇数比来确定多药与常见慢性疾病之间的关联。平均年龄72岁(SD±6.2),以男性居多(53.5%)。比例相对较高,58.7% (n=169)的患者存在多药。7种慢性疾病在约10%的患者中普遍存在。降脂药(80.9%)和抗血小板药(76.4%)是老年人用药最多的两个亚组。随着慢性病患者数量的增加,多种用药的情况也明显增加(p)。本研究得出结论,多种用药在住院老年人中很常见,并且随着住院人数的增加而增加。处方抗血栓和脂质调节剂的倾向增加。这些发现提示了对老年患者进行药物调节和回顾的必要性。需要针对更广泛人群的进一步研究来确定老年人多重用药的适宜性。
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Chronic illnesses and polypharmacy in elderly patients: A hospital-based study in Northern Sri Lanka
Population aging and multiple pathology among older people have increased medicines use in elderly. Aim of this study was to evaluate chronic illnesses and polypharmacy and to determine factors associated with polypharmacy among hospitalized elderly at Teaching Hospital-Jaffna. This was a cross sectional, descriptive study. Elderly and polypharmacy were defined as ≥65years and concomitant use of ≥6 medications for ≥1 month respectively. Data were collected from bedhead-tickets of 288 elderly patients using data extraction sheet. Chi-squared and paired t-test were performed to determine the level of significance and unadjusted odd ratios were calculated to determine the association between polypharmacy and common chronic illnesses. A p value Mean age was 72 (SD±6.2) and majority were males (53.5%). Relatively higher proportion, 58.7% (n=169) of patients had polypharmacy. Seven chronic illnesses were prevalent in >10% of the patients. Lipid-modifying (80.9%) and antithombotic agents (76.4%) were the top two subgroups prescribed to elderly. Polypharmacy was substantially increased with increasing number of chronic illnesses (p This study concluded that polypharmacy was common among hospitalized elderly and increases with hospitalization. There was increased tendency to prescribe antithrombotic and lipid-modifying agents. These findings indicate the need for medication reconciliation and review in elderly patient. Further studies targeting wider population are needed to determine the appropriateness of polypharmacy in elderly.
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