原住民初级保健中的药物和认知风险:一个横截面研究
Marycarol Holdaway1, Zoë Hyde2, Jo-Anne Hughson1
1Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
Internal medicine journal
|December 30, 2023
概括
低于最佳的处方,包括多药和可能不合适的药物,在老年土著和托雷斯海峡岛民中很普遍. 抑郁症和认知问题与这些药物风险有关,这凸显了药物审查的必要性.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 土著健康土著健康
背景情况:
- 年长的土著和托雷斯海峡岛民经历了高的并发病率.
- 在这个人口群体中,低于最佳的处方仍未得到充分研究.
研究的目的:
- 通过原住民社区控制卫生服务 (ACCHSs) 确定通过原住民社区控制卫生服务 (ACCHSs) 在初级保健中老年患者中潜在的低于最佳处方的流行率.
- 在这个人群中确定与非最佳处方相关的风险因素.
主要方法:
- 对50岁及以上的420名系统选择的患者的医疗记录进行了审计.
- 评估使用Beers标准的多药性 (≥5种药物),可能不合适的药物 (PIM) 和抗胆固醇负担 (ACB).
- 后勤回归分析,以探索相关的风险因素.
主要成果:
- 流行率:43%的多药,18%的PIM和12%的ACB得分≥3.3.
- 多药在农村患者中不太常见,在诸如心脏病,心房动,高血压,糖尿病和抑郁症等并发症中更常见.
- 在女性中,PIM更频繁,并与脏疾病,尿失禁,抑郁症,大量饮酒和认知问题有关.
- 高ACB在农村/偏远地区的患者中不太常见,在病和抑郁症中更常见.
结论:
- 不太理想的处方和抑郁症或认知问题之间的关联是显著的.
- 强调对老年澳大利亚土著人的药物审查和降低处方策略的关键需求.
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