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中国老年肺癌患者多重用药及潜在不适当用药的增加趋势:一项重复横断面研究

Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study.

作者信息

Tian Fangyuan, Chen Zhaoyan, Chen Xi, Zhao Mengnan

机构信息

Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.

Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

出版信息

Front Pharmacol. 2022 Jul 18;13:935764. doi: 10.3389/fphar.2022.935764. eCollection 2022.

Abstract

Polypharmacy and potentially inappropriate medication (PIM) use are frequent in older lung cancer patients. This study aimed to examine the trends of polypharmacy and PIM use and explore risk factors for PIM use based on the 2019 Beers criteria in older Chinese lung cancer outpatients with multimorbidity. A repeated cross-sectional study was conducted using electronic medical data consisting of the prescriptions of older lung cancer outpatients in China from January 2016 to December 2018. Polypharmacy was defined as the use of five or more medications. The 2019 Beers criteria were used to evaluate the PIM use of older cancer outpatients (age ≥65 years), and multivariate logistic regression was used to identify the risk factors for PIM use. A total of 3,286 older lung cancer outpatients and their prescriptions were included in the study. The prevalence of polypharmacy was 14.27% in 2016, 16.55% in 2017, and 18.04% in 2018. The prevalence of PIM use, according to the 2019 Beers criteria, was 31.94% in 2016, 35.78% in 2017, and 42.67% in 2018. The two most frequently used PIMs in older lung cancer outpatients were estazolam and tramadol. The logistic regression demonstrated that age 75 to 79, polypharmacy, irrational use of drugs, and lung cancer accompanied by sleep disorders, anxiety or depression, or pain were positively associated with PIM use in older lung cancer outpatients. The prevalence of polypharmacy and PIM use in older lung cancer outpatients with multimorbidity was high in China, and polypharmacy and PIM use increased over time. Further research on interventions rationing PIM use in the older lung cancer patient population is needed.

摘要

多重用药和潜在不适当用药(PIM)在老年肺癌患者中很常见。本研究旨在基于2019年《Beers标准》,探讨中国老年肺癌合并多种疾病门诊患者多重用药和PIM使用的趋势,并探索PIM使用的危险因素。采用重复横断面研究,使用2016年1月至2018年12月中国老年肺癌门诊患者处方的电子医疗数据。多重用药定义为使用五种或更多药物。采用2019年《Beers标准》评估老年癌症门诊患者(年龄≥65岁)的PIM使用情况,并使用多因素逻辑回归分析确定PIM使用的危险因素。本研究共纳入3286例老年肺癌门诊患者及其处方。多重用药患病率在2016年为14.27%,2017年为16.55%,2018年为18.04%。根据2019年《Beers标准》,PIM使用患病率在2016年为31.94%,2017年为35.78%,2018年为42.67%。老年肺癌门诊患者中最常使用的两种PIM是艾司唑仑和曲马多。逻辑回归分析表明,75至79岁、多重用药、不合理用药以及伴有睡眠障碍、焦虑或抑郁或疼痛的肺癌与老年肺癌门诊患者PIM使用呈正相关。中国老年肺癌合并多种疾病门诊患者多重用药和PIM使用的患病率较高,且多重用药和PIM使用随时间增加。需要对老年肺癌患者群体中限制PIM使用的干预措施进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e45e/9340379/11310b5dc9b8/fphar-13-935764-g001.jpg

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