停止使用高风险药物的社会人口统计差异:一个回顾性队列研究
Katharina Tabea Jungo1,2, Niteesh K Choudhry3, Julie C Lauffenburger3
1Center for Healthcare Delivery Sciences (C4HDS) and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. kjungo@bwh.harvard.edu.
npj aging
|December 18, 2025
概括
老年人中断高风险药物的数量仍然很低,只有22.8%的人停止使用. 黑人成年人更有可能停药,而男性和老年人则不太可能.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年人经常使用高风险药物,与临床指南相反,建议停止使用.
- 这些药物的使用对老年患者的健康构成潜在风险.
研究的目的:
- 评估老年人 (≥65岁) 中高风险药物停用率.
- 检查社会人口统计学因素与高风险药物停用之间的关联.
- 为了识别不同药物类别中停药率的变化.
主要方法:
- 一项回顾性队列研究,利用美国一家大型健康保险公司 (2017-2023) 的行政索赔数据.
- 分析包括729,705名长期使用高风险药物的患者.
- 危险比率 (HR) 和95%置信区间 (CI) 被计算出来,以评估停止治疗的可能性.
主要成果:
- 只有22.8%的老年人停止使用高风险药物超过90天.
- 黑人成年人中断率较高 (HR=1.07),特别是在2020-2021年.
- 男人 (HR=0.89) 和75岁以上的成年人 (HR=0.86) 断药的可能性较小.
- 综合男性性别和年龄较大的人群,停药率增加 (HR=1.04).
- 停药因药物类别而异,中枢神经系统,肠道和疼痛药物有差异,但内分泌或心血管药物没有.
结论:
- 在老年人中观察到持续低的高风险药物停用率.
- 社会人口统计学因素,包括种族和年龄,影响戒断.
- 有针对性的干预措施是必要的,以减少老年人群中不适当的药物使用.
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