Background Contemporary data on the quantity and quality of medication use among older adults are lacking. This study examined recent trends in number and appropriateness of prescription medication use among older adults in the US. Method Data from the National Health and Nutrition Examination Survey (NHANES) between 2011 and March 2020 were used and 6336 adult participants aged 65 and older were included. We examined the number of prescription medication, prevalence of polypharmacy (≥5 prescription drugs), use of potentially inappropriate medication (PIM), and use of recommended medications (ACEI/ARBs plus beta-blockers among patients with heart failure and ACEI/ARBs among patients with albuminuria). Results There has been a slight increase in the prevalence of polypharmacy (39.3% in 2011-2012 to 43.8% in 2017-2020, p for trend= 0.32). Antihypertensive, antihyperlipidemic, antidiabetic medications, and antidepressants are the most commonly used medications. There was no substantial change in the use of PIM (17.0% to 14.7%). Less than 50% of older adults with heart failure received ACEI/ARBs plus beta-blockers (44.3% in 2017-2020) and approximately 50% patients with albuminuria received ACEI/ARBs (54.0 in 2017-2020), with no improvement over the study period. Polypharmacy, older age, female, and lower socioeconomic status generally were associated with greater use of PIM but lower use of recommended medications. Conclusions The medication burden remained high among older adults in the US and the appropriate utilization of medications did not improve in the recent decade. Our results underscore the need for greater attentions and interventions to the quality of medication use among older adults.

中文翻译：

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美国社区老年人处方药使用数量和适当性趋势：2011-2020 年


背景 缺乏有关老年人用药数量和质量的当代数据。这项研究调查了美国老年人处方药使用数量和适当性的最新趋势。方法 使用 2011 年至 2020 年 3 月期间全国健康和营养检查调查 (NHANES) 的数据，纳入 6336 名 65 岁及以上的成年参与者。我们检查了处方药的数量、多重用药的患病率（≥5种处方药）、潜在不适当药物的使用（PIM）以及推荐药物的使用（心力衰竭患者中的​​ACEI/ARB加β受体阻滞剂以及心力衰竭患者中的​​ACEI/ARB）蛋白尿患者）。结果 多重用药的患病率略有上升（2011-2012 年为 39.3%，2017-2020 年为 43.8%，趋势 p = 0.32）。抗高血压、抗高血脂、抗糖尿病药物和抗抑郁药物是最常用的药物。 PIM的使用没有显着变化（17.0%至14.7%）。不到 50% 的心力衰竭老年人接受 ACEI/ARB 联合 β 受体阻滞剂治疗（2017-2020 年为 44.3%），约 50% 的蛋白尿患者接受 ACEI/ARB 治疗（2017-2020 年为 54.0），与学习期间。多重用药、年龄较大、女性和较低的社会经济地位通常与 PIM 的更多使用有关，但推荐药物的使用较少。结论 近十年来，美国老年人的药物负担仍然很高，药物的合理利用并没有得到改善。我们的结果强调需要更多地关注和干预老年人的用药质量。