Trends in Drug Duplications in Swedish Older Adults: A Nationwide Register Study from 2006 to 2021

IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Drugs & Aging Pub Date : 2024-09-13 DOI:10.1007/s40266-024-01145-6

Tatiana Erhan, Jonas W. Wastesson, Johan Fastbom

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Abstract

Background

Drug duplication (DD), the use of two identical drugs simultaneously, is a medication error increasing the risk of adverse drug events. We describe the trends and implicated drugs in potential DD in older adults in Sweden from 2006 to 2021.

Methods

We conducted a register-based, repeated cross-sectional study of all older adults (aged ≥65 years) dispensed drugs at a community pharmacy in 2006–2021. DD was defined as a ≥30-day overlap of two dispensations of drugs with the same 5th level (chemical substance) Anatomical Therapeutic Chemical (ATC) classification, but with different brand names, within a 3-month period each year.

Results

Among Swedish older adults with ordinary prescriptions (i.e. multidose excluded; n ≈ 1,200,000–1,600,000 per year), the prevalence of potential DD increased from 5.2% to 10.6% in 65- to 79-year-olds and from 7.0% to 11.7% in those aged ≥80 years. The drug groups (ATC level 3; pharmacological subgroup) most frequently implicated in DD in 2006 were β-blocking agents, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers, and in 2021 Vitamin B12 and folic acid, β-blocking agents and angiotensin II receptor blockers.

Conclusions

DD represents a common but unnecessary and potentially hazardous medication error. Our results indicate that during the last two decades, the prevalence has almost doubled in older adults with ordinary prescriptions, reaching 11% in 2021. More national efforts are needed to revert this trend, including a nationally available complete drug list for all patients, and prescriber support to detect DD.

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瑞典老年人重复用药的趋势：2006 年至 2021 年全国登记研究

背景重复用药（DD）是指同时使用两种相同的药物，这种用药错误会增加药物不良事件的风险。我们对 2006-2021 年间在社区药房配药的所有老年人（年龄≥65 岁）进行了一项基于登记的重复横断面研究。DD的定义是在每年的3个月内，两次配药的第5级（化学物质）解剖学治疗化学（ATC）分类相同，但品牌名称不同，且重叠时间≥30天。结果在开具普通处方的瑞典老年人中（即不包括多剂量处方；n ≈ 每年 1,200,000-1,600,000 人），65 岁至 79 岁老年人的潜在 DD 患病率从 5.2% 上升到 10.6%，≥80 岁老年人的患病率从 7.0% 上升到 11.7%。2006 年，DD 最常涉及的药物类别（ATC 3 级；药理亚组）为 β 受体阻滞剂、血管紧张素转换酶 (ACE) 抑制剂和钙通道阻滞剂，2021 年为维生素 B12 和叶酸、β 受体阻滞剂和血管紧张素 II 受体阻滞剂。我们的研究结果表明，在过去二十年中，老年人使用普通处方用药的比例几乎翻了一番，到 2021 年将达到 11%。为扭转这一趋势，全国需要做出更多努力，包括在全国范围内为所有患者提供完整的药物清单，以及为处方医生提供检测 DD 的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drugs & Aging 医学-老年医学

CiteScore

5.50

自引率

7.10%

发文量

审稿时长

6-12 weeks

期刊介绍： Drugs & Aging delivers essential information on the most important aspects of drug therapy to professionals involved in the care of the elderly. The journal addresses in a timely way the major issues relating to drug therapy in older adults including: the management of specific diseases, particularly those associated with aging, age-related physiological changes impacting drug therapy, drug utilization and prescribing in the elderly, polypharmacy and drug interactions.