背景:许多老年人至少患有一种慢性疾病。因此,应该使用多种药物。由于这些慢性药物对胃的有害影响,可能会发生胃肠道并发症。该研究旨在评估服用慢性药物的患者上消化道并发症的患病率,这些症状的严重程度,以及他们是否服用任何胃保护药物。
方法:这是一项横断面研究,通过来自专科医院内部门诊的面对面问卷调查。该研究包括服用至少一种慢性药物的慢性病患者。数据收集表单用于收集信息。使用简短形式的利兹消化不良问卷(SF-LDQ)评估上消化道症状的严重程度。使用21版社会科学统计软件包(SPSS)进行统计分析。
结果:共纳入400例使用多种药物治疗的慢性病患者。其中,53.8%是女性,56%是已婚,58.5%失业,70%的人不是吸烟者。平均年龄为54.7±17.5岁。患者中最常见的合并症是糖尿病,高血压,和关节炎,百分比为44.3%,38%,和27.3%,分别。使用的慢性药物的平均数量为3.36±1.6,范围为1至9。最常用的是阿司匹林,比例为50%,其次是阿托伐他汀,比索洛尔,和胰岛素的百分比为29.5%,25%,和20.3%,分别。在400名参与者中,362(90.5%)患有消化不良等上消化道副作用(65.8%),胃灼热(78.3%),恶心(48.8%),反流(52.0%)。基于SF-LDQ评分,在400名受访者中,235(58.8%),109(27.3%)和18(4.5%)患有轻度,中度和重度消化不良,分别。高百分比的325(81.3%)的参与者被处方为胃保护药物。质子泵抑制剂是209例(52.3%)患者中处方最多的组。消化不良与年龄显著相关(p值=0.001),受过教育(p值=0.031),不是单一的(p值<0.001),有医疗保险(p值=0.021),作为吸烟者(p值=0.003),使用≥5种药物(p值<0.001)。
结论:慢性疾病患者上消化道并发症非常常见。幸运的是,大多数情况下症状轻微。风险随着年龄和使用更多药物而增加。重要的是检查患者的药物,避免过度使用,除了在需要时使用胃保护剂。
BACKGROUND: Many old people have at least one chronic disease. As a result, multiple drugs should be used. Gastrointestinal complications may occur because of the harmful effects of these chronic drugs on the stomach. The
study aimed to assess the prevalence of upper gastrointestinal complications in patients taking chronic medications, the severity of these symptoms, and whether they take any gastro-protective drugs or not.
METHODS: This was a cross-sectional
study through face-to-face questionnaires from internal outpatient clinics at a specialized hospital. Patients with chronic diseases who were taking at least one chronic medication were included in the
study. Data Collection Form was used to gather information. The Short-Form Leeds
Dyspepsia Questionnaire (SF-LDQ) was used to evaluate the severity of the upper gastrointestinal symptoms. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21.
RESULTS: A total of 400 patients with chronic diseases and using multiple medications were included. Among them, 53.8% were females and 56% were married, 58.5% were unemployed, 70% were not smokers, the mean age was 54.7 ± 17.5 years. The most common comorbid diseases among the patients were diabetes, hypertension, and arthritis, with percentages of 44.3%, 38%, and 27.3%, respectively. The mean number of chronic medications used was 3.36 ± 1.6 with a range of 1 to 9. The most commonly used was aspirin with a percentage of 50%, followed by atorvastatin, bisoprolol, and insulin with percentages of 29.5%, 25%, and 20.3%, respectively. Among the 400 participants, 362 (90.5%) suffered from upper gastrointestinal side effects like indigestion (65.8%), heartburn (78.3%), nausea (48.8%), and regurgitation (52.0%). Based on SF-LDQ scoring, of the 400 respondents, 235(58.8%), 109(27.3%) and 18(4.5%) suffered from mild, moderate and severe dyspepsia, respectively. A high percentage 325 (81.3%) of participants were prescribed gastro-protective medications. Proton pump inhibitors were the most prescribed group in 209 (52.3%) patients.
Dyspepsia was significantly associated with older age (p-value = 0.001), being educated (p-value = 0.031), not being single (p-value < 0.001), having health insurance (p-value = 0.021), being a smoker (p-value = 0.003), and using ≥ 5 medications (p-value < 0.001).
CONCLUSIONS: Upper gastrointestinal complications among patients with chronic diseases were very common. Fortunately, the symptoms were mild in most cases. The risk increased with age and using a higher number of medications. It is important to review patients\' medications and avoid overuse of them, in addition to use gastro-protective agents when needed.