Risk of Polypharmacy Estimated with a Large Claims Database: Fracture Associated with Polypharmacy of Fall-risk-inducing Medications
| Project/Area Number |
15K08121
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Medical pharmacy
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| Research Institution | Tokushima Bunri University |
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Principal Investigator |
Iihara Naomi 徳島文理大学, 薬学部, 教授 (40412390)
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| Co-Investigator(Kenkyū-buntansha) |
吉田 知司 徳島文理大学, 保健福祉学部, 教授 (80220656)
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| Research Collaborator |
Ohara Masaki
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2016: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2015: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
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| Keywords | ポリファーマシー / 骨折 / 高齢者 / 中枢神経系用薬 / 多剤併用 / 受診医療機関 / 骨粗鬆症 / 副作用 / レセプトデータ / 薬剤疫学 / 転倒 |
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| Outline of Final Research Achievements |
Risk of fragility fracture associated with concomitant use of fall-risk-inducing medications (central nervous system [CNS) agents] was estimated with a large claims database. Approximately 450,000 older people who had lived without hospitalization for at least 13 months and had not used opioids but subsequently sustained fragility fractures from May 2013 to September 2014 were analysed.
Risk of fragility fracture rose almost linearly with increasing number of prescribed CNS agents. The increased risk was robust across distinct subgroups. The risk of fragility fracture at least doubled compared with non-use if five or more CNS agents were used concomitantly. The number of CNS agents increased in parallel with the number of hospitals or clinics patients visited. People in Japan can visit as many hospitals or clinics as they prefer, and as often as they like. Sharing of medication records across medical institutions is needed.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究で用いた大規模レセプト情報「レセプト情報・特定健診等情報データベース（NDB Japan）」は、悉皆性にすぐれ、国民が使用した医薬品を、処方された医療機関に関係なく、患者ごとにレトロスペクティブに解析することが可能なデータベースである。この情報を用いて、脳に作用するふらつきを及ぼす薬を何成分も併用すると、軽微な力で生じる骨折の発症リスクが高まることを高齢者において示した。日本は、国民が望む医療機関を制限なく受診でき多くの医薬品が併用されがちである。服薬情報の、施設を越えた一元的管理を可能とする仕組みの完成が急がれる。
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Report
(6 results)
Research Products
(12 results)
