Polypharmacy and the Contributing Factors Among Elderly Patients in Shashemene Referral Hospital, West Arsi, Oromia Region, Ethiopia

Gudeta Duga Geresu, Tadele Mekuria Yadesa, Bontu Aschale Abebe
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引用次数: 5

Abstract

Background: Population ageing is a result of high life expectancy and declining fertility. Medication use in older people is a particular public health concern since the older population has a higher prevalence of multiple drug use referred to as ‘poly-pharmacy’. This study aimed to determine poly-pharmacy and the contributing factors among elderly patients at Shashemene Referral Hospital. Materials and methods: A Health facility based prospective cross sectional study was conducted. Elders of 65 and above years old were enrolled. Data was analyzed by SPSS version 16.0 software. Logistic regression analysis was used to assess association of variables with poly-pharmacy. Statistical significance was conducted at p-value<0.05. Results: The total number of population enrolled in the study was 116 elders (60 yrs old and above). Among this, 59.5% were males. The primary diagnosis of most patients was infection (50% (n=58)) and followed by cardiovascular disorders (18.1% (n=21)). The widely used drug group was antimicrobials (58.7%), followed by cardiovascular (25%) and GIT drugs (13.8%). Almost half, (48.3%), of population were taking 1-2 drugs. The maximum total number of drug per patient was seven drugs of the same or different classes. Poly-pharmacy was observed among almost one-third (32.75%) of study subjects with highest prevalence among younger elders (65yrs-69 yrs old). The polypharmacy that has been seen in elderly in highest prevalence was appropriate poly-pharmacy, 79%. Co-morbidity (AOR=7.427) and occupation, employee, (AOR=8.840) were the contributing factors of poly-pharmacy. Conclusion and recommendations: In this study, a total of 116 elderly patients, 69 males and 47 females, were involved. The primary diagnosis of most patients was infection. Co-morbidity has been seen in over one-third of the study subjects. The widely used drug group was antimicrobials, followed by cardiovascular. The study also shows that poly-pharmacy was prevalent in almost one third of the elderly patients in SRH. The multivariate logistic regression showed that co-morbidity and occupation, employee, were the factors independently associated with poly-pharmacy. The health care system should improve the prescribing process among elderly patients.
埃塞俄比亚奥罗米亚地区西阿尔西市沙什梅内转诊医院老年患者多药及影响因素分析
背景:人口老龄化是预期寿命延长和生育率下降的结果。老年人的药物使用是一个特别值得关注的公共卫生问题,因为老年人使用多种药物的比例更高,称为“多种药房”。本研究旨在了解沙石门转诊医院老年患者使用多种药物的情况及其影响因素。材料和方法:进行了一项基于卫生机构的前瞻性横断面研究。65岁及以上的长者均可参加。数据采用SPSS 16.0软件进行分析。采用Logistic回归分析评估变量与多药的相关性。p值<0.05,差异有统计学意义。结果:入组总人数116人(60岁及以上)。其中,男性占59.5%。大多数患者的主要诊断是感染(50% (n=58)),其次是心血管疾病(18.1% (n=21))。使用最多的药物组是抗菌素类药物(58.7%),其次是心血管类药物(25%)和胃肠道药物(13.8%)。近一半(48.3%)的人口在服用1-2种药物。每名患者最多使用7种相同或不同类别的药物。近三分之一(32.75%)的研究对象存在多重用药现象,其中65岁至69岁的老年人患病率最高。老年人多药发生率最高的是适当多药,占79%。共同发病(AOR=7.427)和职业、员工(AOR=8.840)是影响多药的因素。结论与建议:本研究共纳入116例老年患者,其中男性69例,女性47例。多数患者的初步诊断为感染。超过三分之一的研究对象出现了合并症。使用最广泛的药物组是抗菌素,其次是心血管药物。该研究还表明,近三分之一的SRH老年患者普遍存在多种药房。多因素logistic回归分析显示,合并症、职业、员工是与多药相关的独立因素。医疗保健系统应改进老年患者的处方流程。
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