イランの高齢者における薬物使用パターンとポリファーマシー:国家医療保険請求データを用いた横断的研究
Seyed Mohammad-Navid Ataei1, Ali Golestani1, Sepehr Khosravi1
1Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
BMJ open
|August 21, 2025
まとめ
ポリファーマはイランで広く使われている.
科学分野:
- 高齢者医療
- 公衆衛生
- 薬学経済学
背景:
- 多剤薬は高齢者にとって 特に中所得国では 大きな課題です
- イランの高齢者層は 薬物管理に懸念が高まっています
研究 の 目的:
- イランの高齢者の間で多剤薬の普及とパターンを調査する.
- ポリファーマシーに関連する一般的な薬剤のクラスと薬剤の組み合わせを特定する.
- 政策決定を促し,高齢者の医薬品の安全性を高める.
主な方法:
- 全国規模の健康保険請求データを利用した,人口ベースの遡及的観察研究です.
- 2014年から2017年まで,イランの健康保険機関 (IHIO) に保険に入っていた1,876,527人のデータを分析した.
- 複製薬は5種類以上の薬物を用いるものと定義され,分析には累積的および連続的な複製薬,ロジスティック回帰および関連ルールマイニングが含まれる.
主要な成果:
- 累積的な多用薬剤の有病率は6ヶ月以上で74. 9%,1ヶ月以上で64. 6%であった.
- 女性と75歳から79歳の個人は,ポリファーマシーに強い傾向を示した.
- 一般的に使用される薬剤は,全身性グルココルチコイド,HMG-CoA還元酵素阻害剤,血小板凝集阻害剤を含み,食道,心血管,神経,血液系に影響を与える薬剤に強い関連性が見られた.
結論:
- ポリファーマはイランの高齢者間で広く普及しており,性別,年齢,保険,地域によって顕著な違いがあります.
- この調査結果は,ポリファーマを効果的に管理し,この集団における医薬品の安全性を改善するために,標的を絞った介入の必要性を強調しています.
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