Treatment status of patients over 65 years old with hypertension and multimorbidity in Qinghai / 公共卫生与预防医学

ABSTRACT

Objective To investigate the treatment status of patients over 65 years old with hypertension and multimorbidity in Qinghai, so as to provide reference for clinical treatment. Methods A total of 530 patients aged over 65 years old with hypertension involved multimorbidity in Qinghai were enrolled. The main disease types and polypharmacy were analyzed. Living with Medicines Questionnaire (LMQ) was used to assess the medical burden of patients, and the potentially inappropriate medication (PIM) was measured using screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria. Various indexes were analyzed, including age, gender, working status, marital status, educational level, solitary life, primary caregiver, sources of income, types of diseases, number of drugs per prescription and ways of obtaining prescriptions. The independent factors of irrational drug use in patients with hypertension and multimorbidity were discussed. Results ① Among the 530 subjects, the proportion of patients complicated with two diseases, three diseases, and four or more diseases was 71.70%, 20.00% and 8.30%, respectively. ② The top five combination types of multimorbidity were hypertension with coronary heart disease (26.04%), hypertension with dyslipidemia (16.04%), hypertension with diabetes (13.02%), hypertension with coronary heart disease and dyslipidemia (7.55%), hypertension with coronary heart disease and diabetes (3.96%).③ The types of drugs per prescription ranged from 1 to 11, with an average of 6.13 types, and the multiple medication rate reached 83.02% (440/530). ④ LMQ scale indicated that drug burden of patients with multimorbidity was at moderate to severe degree. ⑤ Taking STOPP/START as standard, the incidence of PIM was 32.64%.⑥ Multivariate Logistic regression analysis showed that education level and prescription obtained from secondary or above level hospitals were protective factors for PIM in patients with hypertension and multiple diseases, while the type of medication was a risk factor for PIM. Conclusion The elderly patients with hypertension and multiple diseases in Qinghai have a high multiple medication rate, and are in a state of moderate to severe drug burden, moreover, the PIM rate is also relatively high, so clinical standardization of drug use and reduction of drug burden are of vital importance.