Caroline Krüger, Ingmar Schäfer, Hendrik van den Bussche, Michael Baehr, Horst Bickel, Angela Fuchs, Jochen Gensichen, Wolfgang Maier, Steffi G Riedel-Heller, Hans-Helmut König, Anne Dahlhaus, Gerhard Schön, Siegfried Weyerer, Birgitt Wiese, Wolfgang von Renteln-Kruse, Claudia Langebrake, Martin Scherer
{"title":"初级保健中多病老年患者处方药和非处方药使用模式的非随机关系:多中心观察性队列研究MultiCare的探索性分析数据","authors":"Caroline Krüger, Ingmar Schäfer, Hendrik van den Bussche, Michael Baehr, Horst Bickel, Angela Fuchs, Jochen Gensichen, Wolfgang Maier, Steffi G Riedel-Heller, Hans-Helmut König, Anne Dahlhaus, Gerhard Schön, Siegfried Weyerer, Birgitt Wiese, Wolfgang von Renteln-Kruse, Claudia Langebrake, Martin Scherer","doi":"10.1080/13814788.2021.1933425","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The elderly population deals with multimorbidity (three chronic conditions) and increasinged drug use with age. A comprehensive characterisation of the medication - including prescription and over-the-counter (OTC) drugs - of elderly patients in primary care is still insufficient.</p><p><strong>Objectives: </strong>This study aims to characterise the medication (prescription and OTC) of multimorbid elderly patients in primary care and living at home by identifying drug patterns to evaluate the relationship between drugs and drug groups and reveal associations with recently published multimorbidity clusters of the same cohort.</p><p><strong>Methods: </strong>MultiCare was a multicentre, prospective, observational cohort study of 3189 multimorbid patients aged 65 to 85 years in primary care in Germany. Patients and general practitioners were interviewed between 2008 and 2009. Drug patterns were identified using exploratory factor analysis. The relations between the drug patterns with the three multimorbidity clusters were analysed with Spearman-Rank-Correlation.</p><p><strong>Results: </strong>Patients (59.3% female) used in mean 7.7 drugs; in total 24,535 drugs (23.7% OTC) were detected. Five drug patterns for men (drugs for obstructive pulmonary diseases (D-OPD), drugs for coronary heart diseases and hypertension (D-CHD), drugs for osteoporosis (D-Osteo), drugs for heart failure and drugs for pain) and four drug patterns for women (D-Osteo, D-CHD, D-OPD and drugs for diuretics and gout) were detected. Significant associations between multimorbidity clusters and drug patterns were detectable (D-CHD and CMD: male: <i>ρ</i> = 0.376, CI 0.322-0.430; female: <i>ρ</i> = 0.301, CI 0.624-0.340).</p><p><strong>Conclusion: </strong>The drug patterns demonstrate non-random relations in drug use in multimorbid elderly patients and systematic associations between drug patterns and multimorbidity clusters were found in primary care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13814788.2021.1933425","citationCount":"1","resultStr":"{\"title\":\"Non-random relations in drug use expressed as patterns comprising prescription and over-the-counter drugs in multimorbid elderly patients in primary care: Data of the exploratory analysis of the multicentre, observational cohort study MultiCare.\",\"authors\":\"Caroline Krüger, Ingmar Schäfer, Hendrik van den Bussche, Michael Baehr, Horst Bickel, Angela Fuchs, Jochen Gensichen, Wolfgang Maier, Steffi G Riedel-Heller, Hans-Helmut König, Anne Dahlhaus, Gerhard Schön, Siegfried Weyerer, Birgitt Wiese, Wolfgang von Renteln-Kruse, Claudia Langebrake, Martin Scherer\",\"doi\":\"10.1080/13814788.2021.1933425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The elderly population deals with multimorbidity (three chronic conditions) and increasinged drug use with age. 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The relations between the drug patterns with the three multimorbidity clusters were analysed with Spearman-Rank-Correlation.</p><p><strong>Results: </strong>Patients (59.3% female) used in mean 7.7 drugs; in total 24,535 drugs (23.7% OTC) were detected. Five drug patterns for men (drugs for obstructive pulmonary diseases (D-OPD), drugs for coronary heart diseases and hypertension (D-CHD), drugs for osteoporosis (D-Osteo), drugs for heart failure and drugs for pain) and four drug patterns for women (D-Osteo, D-CHD, D-OPD and drugs for diuretics and gout) were detected. Significant associations between multimorbidity clusters and drug patterns were detectable (D-CHD and CMD: male: <i>ρ</i> = 0.376, CI 0.322-0.430; female: <i>ρ</i> = 0.301, CI 0.624-0.340).</p><p><strong>Conclusion: </strong>The drug patterns demonstrate non-random relations in drug use in multimorbid elderly patients and systematic associations between drug patterns and multimorbidity clusters were found in primary care.</p>\",\"PeriodicalId\":54380,\"journal\":{\"name\":\"European Journal of General Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2021-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1080/13814788.2021.1933425\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of General Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13814788.2021.1933425\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of General Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13814788.2021.1933425","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 1
摘要
背景:老年人群面临多种疾病(三种慢性疾病)和随着年龄增长而增加的药物使用。对初级保健中老年患者的药物——包括处方药和非处方药(OTC)——的全面描述仍然不够。目的:本研究旨在通过识别药物模式来评估药物和药物组之间的关系，并揭示与最近发表的同一队列的多病集群的关联，从而表征初级保健和居家生活的多病老年患者的用药(处方和OTC)。方法:MultiCare是一项多中心、前瞻性、观察性队列研究，在德国进行了3189例年龄在65至85岁的多病患者的初级保健。患者和全科医生在2008年至2009年间接受了采访。使用探索性因子分析确定药物模式。采用spearman - rank相关分析药物类型与3种多病聚类之间的关系。结果:患者平均使用7.7种药物，女性占59.3%;共检出药品24535种，其中OTC占23.7%。检测到男性的五种药物模式(阻塞性肺疾病药物(D-OPD)、冠心病和高血压药物(D-CHD)、骨质疏松药物(D-Osteo)、心力衰竭药物和疼痛药物)和女性的四种药物模式(D-Osteo、D-CHD、D-OPD以及利尿剂和痛风药物)。多病集群与药物模式之间存在显著相关性(D-CHD和CMD:男性:ρ = 0.376, CI 0.322-0.430;女性:ρ = 0.301, CI 0.624-0.340)。结论:老年多病患者用药模式具有非随机关系，在初级保健中，用药模式与多病聚集性存在系统关联。
Non-random relations in drug use expressed as patterns comprising prescription and over-the-counter drugs in multimorbid elderly patients in primary care: Data of the exploratory analysis of the multicentre, observational cohort study MultiCare.
Background: The elderly population deals with multimorbidity (three chronic conditions) and increasinged drug use with age. A comprehensive characterisation of the medication - including prescription and over-the-counter (OTC) drugs - of elderly patients in primary care is still insufficient.
Objectives: This study aims to characterise the medication (prescription and OTC) of multimorbid elderly patients in primary care and living at home by identifying drug patterns to evaluate the relationship between drugs and drug groups and reveal associations with recently published multimorbidity clusters of the same cohort.
Methods: MultiCare was a multicentre, prospective, observational cohort study of 3189 multimorbid patients aged 65 to 85 years in primary care in Germany. Patients and general practitioners were interviewed between 2008 and 2009. Drug patterns were identified using exploratory factor analysis. The relations between the drug patterns with the three multimorbidity clusters were analysed with Spearman-Rank-Correlation.
Results: Patients (59.3% female) used in mean 7.7 drugs; in total 24,535 drugs (23.7% OTC) were detected. Five drug patterns for men (drugs for obstructive pulmonary diseases (D-OPD), drugs for coronary heart diseases and hypertension (D-CHD), drugs for osteoporosis (D-Osteo), drugs for heart failure and drugs for pain) and four drug patterns for women (D-Osteo, D-CHD, D-OPD and drugs for diuretics and gout) were detected. Significant associations between multimorbidity clusters and drug patterns were detectable (D-CHD and CMD: male: ρ = 0.376, CI 0.322-0.430; female: ρ = 0.301, CI 0.624-0.340).
Conclusion: The drug patterns demonstrate non-random relations in drug use in multimorbid elderly patients and systematic associations between drug patterns and multimorbidity clusters were found in primary care.
期刊介绍：
The EJGP aims to:
foster scientific research in primary care medicine (family medicine, general practice) in Europe
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The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology.
Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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