PDF(Pubmed)
Abstract：
BACKGROUND: Polypharmacy is a global public health concern. This study aimed to determine the prevalence of polypharmacy and trends in the use of commonly used and potentially inappropriate medications among older Korean patients.
METHODS: Individuals aged ≥ 65 years who were prescribed any medication between 2014 and 2018 were selected from the Korean National Health Information Database. Joinpoint regression analyses were used to determine trends in the age-adjusted polypharmacy rates by age group. The prescription rates of the most commonly used medications and the most commonly used potentially inappropriate medications were analysed by year or age group for patients with polypharmacy using the chi-square and proportion difference tests.
RESULTS: This study included 1,849,968 patients, 661,206 (35.7%) of whom had polypharmacy. Age-adjusted polypharmacy rates increased significantly between 2014 and 2018 (P = 0.046). Among patients with polypharmacy, the most commonly prescribed medications were aspirin (100 mg), atorvastatin, metformin, glimepiride, and rosuvastatin. The most commonly prescribed and potentially inappropriate medications were alprazolam, diazepam, amitriptyline, zolpidem, and dimenhydrinate. There was a significant decrease in the prescription rates for each of these drugs in 2018 compared with 2014 among patients with polypharmacy (all P < 0.001), whereas there was a significant increase in alprazolam prescription among patients aged ≥ 85 years when analysed by age group (P < 0.001).
CONCLUSIONS: This study revealed an increasing prevalence of polypharmacy among older adults. Additionally, it highlighted that the utilisation of commonly prescribed potentially inappropriate medications, such as benzodiazepines and tricyclic antidepressants, has remained persistent, particularly among patients aged ≥ 85 years who practiced polypharmacy. These findings provide evidence-based guidance for the development of robust polypharmacy management strategies to ensure medication safety among older adults.
METHODS: Individuals aged ≥ 65 years who were prescribed any medication between 2014 and 2018 were selected from the Korean National Health Information Database. Joinpoint regression analyses were used to determine trends in the age-adjusted polypharmacy rates by age group. The prescription rates of the most commonly used medications and the most commonly used potentially inappropriate medications were analysed by year or age group for patients with polypharmacy using the chi-square and proportion difference tests.
RESULTS: This study included 1,849,968 patients, 661,206 (35.7%) of whom had polypharmacy. Age-adjusted polypharmacy rates increased significantly between 2014 and 2018 (P = 0.046). Among patients with polypharmacy, the most commonly prescribed medications were aspirin (100 mg), atorvastatin, metformin, glimepiride, and rosuvastatin. The most commonly prescribed and potentially inappropriate medications were alprazolam, diazepam, amitriptyline, zolpidem, and dimenhydrinate. There was a significant decrease in the prescription rates for each of these drugs in 2018 compared with 2014 among patients with polypharmacy (all P < 0.001), whereas there was a significant increase in alprazolam prescription among patients aged ≥ 85 years when analysed by age group (P < 0.001).
CONCLUSIONS: This study revealed an increasing prevalence of polypharmacy among older adults. Additionally, it highlighted that the utilisation of commonly prescribed potentially inappropriate medications, such as benzodiazepines and tricyclic antidepressants, has remained persistent, particularly among patients aged ≥ 85 years who practiced polypharmacy. These findings provide evidence-based guidance for the development of robust polypharmacy management strategies to ensure medication safety among older adults.
摘要：
背景：多重用药是一个全球性的公共卫生问题。这项研究旨在确定老年韩国患者中多种药物的患病率以及使用常用和潜在不适当药物的趋势。
方法：从韩国国家健康信息数据库中选择在2014年至2018年期间服用任何药物的年龄≥65岁的个人。Joinpoint回归分析用于确定按年龄组进行年龄调整的多药率的趋势。使用卡方和比例差异检验，按年龄或年龄分析了多药房患者最常用药物和最常用潜在不适当药物的处方率。
结果：本研究包括1,849,968例患者，661,206人（35.7%）有多重用药。年龄调整后的多药率在2014年至2018年期间显着增加（P=0.046）。在多重用药的患者中，最常见的处方药是阿司匹林（100毫克），阿托伐他汀,二甲双胍,格列美脲,和瑞舒伐他汀.最常见的处方和潜在的不适当的药物是阿普唑仑，地西泮,阿米替林,唑吡坦,和dixinhydrinate。与2014年相比，2018年每种药物的处方率在多重用药患者中显著下降（均P<0.001），而在按年龄组分析的≥85岁患者中，阿普唑仑处方显著增加（P<0.001）。
结论：这项研究揭示了老年人中多重用药的患病率增加。此外,它强调了使用通常规定的潜在不适当的药物，例如苯二氮卓类药物和三环类抗抑郁药，仍然坚持不懈，特别是在年龄≥85岁的患者中。这些发现为制定稳健的多重用药管理策略提供了循证指导，以确保老年人的用药安全。
方法：从韩国国家健康信息数据库中选择在2014年至2018年期间服用任何药物的年龄≥65岁的个人。Joinpoint回归分析用于确定按年龄组进行年龄调整的多药率的趋势。使用卡方和比例差异检验，按年龄或年龄分析了多药房患者最常用药物和最常用潜在不适当药物的处方率。
结果：本研究包括1,849,968例患者，661,206人（35.7%）有多重用药。年龄调整后的多药率在2014年至2018年期间显着增加（P=0.046）。在多重用药的患者中，最常见的处方药是阿司匹林（100毫克），阿托伐他汀,二甲双胍,格列美脲,和瑞舒伐他汀.最常见的处方和潜在的不适当的药物是阿普唑仑，地西泮,阿米替林,唑吡坦,和dixinhydrinate。与2014年相比，2018年每种药物的处方率在多重用药患者中显著下降（均P<0.001），而在按年龄组分析的≥85岁患者中，阿普唑仑处方显著增加（P<0.001）。
结论：这项研究揭示了老年人中多重用药的患病率增加。此外,它强调了使用通常规定的潜在不适当的药物，例如苯二氮卓类药物和三环类抗抑郁药，仍然坚持不懈，特别是在年龄≥85岁的患者中。这些发现为制定稳健的多重用药管理策略提供了循证指导，以确保老年人的用药安全。
