Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (1): 93-100.doi: 10.6040/j.issn.1671-7554.0.2021.0913

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Prevalence and influencing factors of polypharmacy in multimorbidity patients in rural areas of Shandong Province

WANG Chunxia1,2, HE Menglu1,2, WANG Haipeng1,2, LI Hui1,2   

  1. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, Shandong, China
  • Published:2022-01-08

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Abstract: Objective To analyze the disease prevalence of multimorbidity and the types, quantity and rationality of polypharmacy in rural areas of Shandong Province, and to explore the influencing factors. Methods In November 2019, 531 patients with multimorbidity from 16 villages in Shandong Province were selected by multistage random sampling method for questionnaire survey to describe the disease situation, medication quantity and type of the patients. Potential inappropriate medication was evaluated according to the Criteria of Potentially Inappropriate Medications for Older Adults in China(2017 edition). Regression analysis was used to analyze the influencing factors. Results Multimorbidity patients complicated with diseases(2.88±0.95)species; the average number of medication was(3.64±1.65)species, and the polypharmacy patients accounted for 24.5%, mainly cardiovascular and endocrine system medication; potential inappropriate medication accounted for 312 cases(58.8%). Logistic regression results showed that gender, number of chronic diseases, self-rated health status were the influencing factors for polypharmacy(P<0.05), and gender and number of medications were the influencing factors for potential inappropriate medication(P<0.05). Conclusion The proportion of potential inappropriate medication in rural patients with multimorbidity is high. It is necessary to strengthen the comprehensive medication management of rural patients with multimorbidity.

Key words: Multimorbidity, Polypharmacy, Potential inappropriate medication, Prevalence, Influencing factor

CLC Number: 

  • R181.3+5
[1] Wang HH, Wang JJ, Wong SY, et al. Epidemiology of multimorbidity in China and implications for the healthcare system: cross-sectional survey among 162,464 community household residents in southern China[J]. BMC Med, 2014, 12(1): 188.
[2] 杨娟,郑晓,侯丽红,等. 太原市老年人多重慢病患病现状及影响因素[J]. 中华疾病控制杂志, 2021, 25(1): 78-83. YANG Juan, ZHENG Xiao, HOU Lihong, et al.The prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan [J]. Chinese Journal of Disease Control & Prevention, 2021, 25(1): 78-83.
[3] 赖小星,霍晓鹏,安奇志,等. 老年病人多重用药现状调查及分析[J]. 护理研究, 2016, 30(19): 2374-2378. LAI Xiaoxing, HUO Xiaopeng, AN Qizhi,et al.Survey and analysis of status quo of polypharmacy in elderly patients[J]. Chinese Nursing Research, 2016, 30(19): 2374-2378.
[4] 康文静. 社区老年慢性病患者多重用药情况及对处方干预的认知分析[J]. 中国老年保健医学, 2020, 18(2): 73-74.
[5] 戚龙,董碧蓉. 老年多病共存临床治疗决策新视角[J]. 现代临床医学, 2014, 40(2): 150-153.
[6] 鲍欣雨,谢易娴,张晓霞,等.多重慢病对社区居民健康相关生命质量的影响分析[J]. 中国卫生经济, 2019, 38(3): 74-77. BAO Xinyu, XIE Yixian, ZHANG Xiaoxia, et al. Analysis on the effects of multimorbidity on health-related quality of life of community residents[J]. Chinese Health Economics, 2019, 38(3): 74-77.
[7] Charlesworth CJ, Smit E, Lee DSH, et al. Polypharmacy among adults aged 65 years and older in the united states: 1988-2010[J]. J Gerontol A Biol Sci Med Sci, 2015, 70(8): 989-995.
[8] 滕晋,王丹,徐熙,等. 老年患者多重用药调查及共病管理的临床策略[J]. 中国卫生事业管理, 2015, 32(9): 695-697. TENG Jin, WANG Dan, XU Xi, et al. Surveying the status of older patients multiple-drug-using behavior and studying on the clinical strategies of comorbidity management[J]. Chinese Health Service Management, 2015, 32(9): 695-697.
[9] 曲国红,智俊娜,陈龙保,等.老年患者多重用药风险及其影响因素分析[J]. 药学与临床研究, 2020, 28(5): 363-366. QU Guohong, ZHI Junna, CHEN Longbao, et al. Analysis of prevalence and risk factors of elderly polymedication outpatients[J]. Pharmaceutical and Clinical Research, 2020, 28(5): 363-366.
[10] 中国老年保健医学研究会老年合理用药分会,中华医学会老年医学分会,中国药学会老年药学专业委员会,等.中国老年人潜在不适当用药判断标准(2017年版)[J]. 药物不良反应杂志, 2018, 20(1): 2-8.
[11] 舒冰,方玉婷,李民,等. 老年多重用药患者潜在不适当用药情况及其影响因素研究[J]. 中国全科医学, 2021, 24(17): 2134-2139. SHU Bing, FANG Yuting, LI Min, et al. Evaluation of potentially inappropriate medication in elderly patients with multiple[J]. Chinese General Practice, 2021, 24(17): 2134-2139.
[12] 刘葳, 于德华, 金花, 等. 社区老年多病共存患者多重用药情况评价研究[J]. 中国全科医学, 2020, 23(13): 1592-1598. LIU Wei, YU Dehua, JIN Hua, et al. Analysis and evaluation of multiple drug use among elderly patients with multiple chronic conditions in community[J]. Chinese General Practice, 2020, 23(13): 1592-1598.
[13] 王佳,常敬涵,刘雨鑫,等. 老年慢性病住院患者多重用药的影响因素研究[J]. 中国医院药学杂志, 2021, 41(6): 606-611. WANG Jia, CHANG Jinghan, LIU Yuxin, et al. Influencing factors of multiple medications in elders with chronic diseases[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(6): 606-611.
[14] 李荔,李莎,卫芸,等. 社区老年人多重用药率及其相关因素的系统综述[J]. 中国全科医学, 2021, 24(25): 3161-3170. LI Li, LI Sha, WEI Yun, et al. Prevalence and factors associated with polypharmacy in community-dwelling older people:a systematic review[J]. Chinese General Practice, 2021, 24(25): 3161-3170.
[15] 侯蕾,徐凌忠,赵伟宁. 山东省农村居民对医疗机构综合评价研究[J]. 山东大学学报(医学版), 2011, 49(12): 157-159. HOU Lei, XU Lingzhong, ZHAO Weining. Comprehensive evaluation of rural residents in Shandong Province of medical institutions[J]. Journal of Shandong University(Health Sciences), 2011, 49(12): 157-159.
[16] 赵奕钧,凡学龙.城乡居民慢性病状况及疾病经济负担分析[J]. 统计与决策, 2017(22): 117-120.
[17] 邱珊娇,唐干益,黄文静,等. Beers标准(2019)和中国老年人潜在不适当用药判断标准(2017版)评估社区老年共病患者的不适当用药分析[J]. 中国全科医学, 2020, 23(S1): 34-38. QIU Shanjiao, TANG Ganyi, HUANG Wenjing, et al. Application of Beers Criteria(2019)and Chinese PIM Criteria(2017 version)to evaluate inappropriate medication for elderly comorbid patients in communities[J]. Chinese General Practice, 2020, 23(S1): 34-38.
[18] 孙艳萍,王烨,邢玉晶,等. 门诊老年患者潜在不适当用药情况调查及影响因素分析[J]. 中国新药杂志, 2018, 27(16): 1939-1944. SUN Yanping, WANG Ye, XING Yujing, et al. Analysis of prevalence and risk factors of potentially inappropriate medication in elderly outpatients[J]. Chinese Journal of New Drugs, 2018, 27(16): 1939-1944.
[19] 任晓晖,朱嘉琳,刘毅,等. 我国乡镇卫生院卫生人力资源政策变迁及影响[J]. 中国农村卫生事业管理, 2020, 40(5): 324-329. REN Xiaohui, ZHU Jialin, LIU Yi, et al. Changes of health human resources policies in township hospitals in China and its impact[J]. Chinese Rural Health Service Administration, 2020, 40(5): 324-329.
[20] 杨庆华,尚楠,郝云娇.某地区农村高血压药物使用情况分析[J]. 中西医结合心脑血管病杂志, 2018, 16(15): 2270-2272.
[21] 李洁琼.农村老年人群降压药物使用及趋势[J]. 中国社区医师, 2016, 32(12): 16-18. LI Jieqiong. The use of antihypertensive drugs and trend in rural elderly population[J]. Chinese Community Doctors, 2016, 32(12): 16-18.
[22] 国家卫生计生委合理用药专家委员会, 中国医师协会高血压专业委员会. 高血压合理用药指南(第2版)[J]. 中国医学前沿杂志(电子版), 2017, 9(7): 28-126.
[23] 龚艳兰,李君荣,蒋丽娟,等. 镇江市社区老年人用药安全性[J]. 中国老年学杂志, 2011, 31(9): 1633-1635.
[24] 胡丽萍,但淑杰,盖红梅,等. 上海某社区老年慢性病共病患者多重用药分析及对生命质量的影响[J]. 药物流行病学杂志, 2020, 29(1): 30-34. HU Liping, DAN Shujie, GAI Hongmei, et al. Analysis of multiple drug use and its impact on quality of life of elderly chronic disease comorbidity patients in a community of Shanghai[J]. Chinese Journal of Pharmacoepidemiology, 2020, 29(1): 30-34.
[25] 刘淼,李嘉琦,吕宪玉,等. ≥80岁老年人多重用药现况及影响因素分析[J]. 中国公共卫生, 2017, 33(3): 412-414. LIU Miao, LI Jiaqi, LYU Xianyu, et al. Prevalence and influencing factors of polypharmacy among persons aged 80 years or older[J]. Chinese Journal of Public Health, 2017, 33(3): 412-414.
[26] 罗林凡,刘强,李娟. 基于老年人潜在不适当用药评价工具基础上的社区高龄慢性病综合管理1例分析[J]. 基层医学论坛, 2021, 25(14): 2054-2056. LUO Linfan, LIU Qiang, LI Juan, et al. A case study of the comprehensive management of elderly chronic diseases in community based on the evaluation tool of potential inappropriate use of drugs for the elderly[J]. The Medical Forum, 2021, 25(14): 2054-2056.
[27] 李秀霞,顾文静,张静芸,等. 甘肃省农村地区医疗用药合理性分析[J]. 中国公共卫生, 2017, 33(3): 419-421. LI Xiuxia, GU Wenjing, ZHANG Jingyun, et al. Rationality of medicine use in rural areas of Gansu Province[J]. Chinese Journal of Public Health, 2017, 33(3): 419-421.
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