Study On The Polypharmacy Cognitive Preference Of Elderly Patients With Chronic Diseases In Shandong Province

BackgroundThe prevalence of chronic diseases in the elderly and the burden of diseases faced by families are increasing year by year,which is also the main feature of aging population in China.As a large country with the largest population in developing countries,China's economic and social development speed can not adapt to the process of population aging.With the growth of the elderly,the development trend of chronic diseases of the elderly gradually shows the characteristics of complexity and complexity.The elderly often coexist with multiple diseases,leading to multiple drug use(Polypharmacy).According to the report released by the State Food and Drug Administration in 2017,the drug safety of the elderly with chronic diseases should be paid special attention to.According to the social research data,in terms of the incidence of adverse reactions caused by drug combination,the incidence of adverse reactions caused by combination of more than five drugs can reach more than 4%,while when the number of combined drugs increases to 6-10,the ratio increases to more than 7%.In the national health expenditure,the drug cost has accounted for half of the total,which shows that the national economy is shouldering a heavy burden due to the sharp rise in drug cost.Research ObjectiveBased on the study of cognitive preference of elderly patients with chronic diseases in Shandong Province,this paper analyzes how different demographic and sociological characteristics,different economic conditions,different personal lifestyles,different health conditions,different medical treatment and drug treatment,and different mental health status of elderly patients with chronic diseases affect their preference for multiple drug use,Suggestions for rational drug use were put forward.Materials and MethodsThe subjects of this study were selected by multistage random sampling.Firstly,three prefecture level cities were selected according to the level of social and economic development and geographical location;then,one district and one county(city)were randomly selected from each prefecture level city;three streets(towns)were randomly selected from each sample area(county);six villages(residents)were randomly selected from each sample Street(township);finally,50 households aged 60 or above were randomly selected from each village(neighborhood).Finally,a questionnaire survey was conducted among 7070 elderly residents over 60 years old.4770 questionnaires with chronic diseases and effective answers to multiple drug preference were selected and analyzed.SPSS20.0 was used for statistical analysis.Main Results1)From demographic sociological factors:compared with those who have neverattended school,those who have only attended primary school have a lower preference rate for multiple drug use,with the ratio of 0.676;compared with those in marriage,those who are not in marriage(unmarried/divorced/widowed)have a higher preference rate of 1.228;compared with retired(retired)and in-service workers,the preference rate of unemployed(no income)is 1.512;compared with the medical insurance of urban workers and the first-class(high-grade)residents,the preference rate of unemployed(no income)is higher.The preference rate of residents in the second(low)and other medical insurance is far lower,the ratio is 0.385 and 0.569 respectively;compared with the commercial insurance the preference rate of no is higher,the ratio is 1.674,and the majority of the residents have no commercial medical insurance.Compared with empty nest and living alone,the preference rate of non empty nest and living alone elderly was higher,with the ratio of 1.421;compared with rural areas,the preference rate of towns and cities was lower,with the ratio of 0.425 and 0.483,respectively,but most of them lived in rural areas.2)Form the perspective of socioeconomic factors:the preference rate of those who are not rich but not worried about their livelihood is higher than those who are rich and do not need to worry about their livelihood,and the ratio is 1.980,and the majority of them are of this kind;compared with the low-income(<2299 yuan),the preference rate of low-income,medium income,medium high-income and high-income is lower.Compared with low<2499 yuan,the preference rate of low,medium,medium high and high were 0.671,0.510,0.657 and 0.748;the preference rates of low,medium,medium high and high were 0.671,0.510,0.657 and 0.748;the preference rate of low medium and medium medical expenses were 1.478 and 1.301 respectively.The ratio was 0.684.3)Different lifestyle analysis:compared with the health examination within 12 months,the preference rate of not doing physical examination was low,and the ratio was 0.707.4)From different health status analysis:compared with the self-rated health status is very good,the preference rate of better and worse self-rated health status is higher,the ratio is 1.567 and 1.524.5)Analysis of medical treatment and drug treatment:the preference rate of intravenous infusion,intramuscular injection and indifference was far lower than that of oral administration,with the ratio of 0.479,0.544 and 0.422 for intravenous infusion,intramuscular injection and indifference;the higher the price and the better the effect,the lower the preference rate of disagreement,the ratio was 0.532,The ratio was 0.525;for the same drug,the preference rate of domestic drug was lower than that of imported drug,and the ratio was 0.770.Conclusion and SuggestionIn order to reduce multiple drug use and strengthen rational drug use,suggestions are as follows:1)To strengthen the rational use of drugs in medical institutions and medical personnel.2)In order to ensure the rational use of drug in medical institutions,the National Health Commission issued a document to regulate the prescription review of medical institutions.All prescriptions should be approved before entering the pricing and allocation process.3)Strengthen the urban and rural primary medical and health institutions to slow down the elderly.4)Strengthen the management of rational drug use through medical insurance policy.5)Objective to improve the awareness of rational drug use in elderly patients with chronic diseases.6)Play the role of family members.