Volume 35, Issue 1 (1-2021)                   Med J Islam Repub Iran 2021 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kamyari N, Soltanian A R, Mahjub H, Moghimbeigi A, Shahali Z. Mapping Drug Prescription, Polypharmacy, and Pharmaceutical Spending in Older Adults in Iran: A Multilevel Analysis Based on Claims Data. Med J Islam Repub Iran 2021; 35 (1) :1190-1201
URL: http://mjiri.iums.ac.ir/article-1-7470-en.html
Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran , soltanian@umsha.ac.ir
Abstract:   (968 Views)
Background: To date, comprehensive data on drug utilization in Iranian people are lacking. The purpose of this study was to graphically describe drug prescription, polypharmacy, and pharmaceutical spending in > 3 million Iranian elderly people.
   Methods: In this multilevel cross-sectional study, using administrative claims data provided by the Iran Health Insurance Organization (IHIO), we assessed drug claims and drug costs in 2018 in >3 million individuals living in Iran and who have been insured with health insurance (Bimeh Salamat). In particular, we analyzed the prevalence of polypharmacy and pharmaceutical spending use according to the annual Report of Iranian Health Insurance Organization. Multilevel ordinal logistic and multilevel beta regression models were used to analyze the data. Significance level was set as P ≤ .05 and CI at 95%.
   Results: Nationally, the mean number of drug prescriptions per patient was 1.46 (SD, 0.81). The mean number of prescribed drugs per patient was 4.32 (SD, = 3.04). The drug cost for each elderly patient was $6.86 (interquartile range (IQR), 12.26), with $4.96 and $1.76 for the insurance and the insured shares, respectively. For elderly women, the odds of polypharmacy (excessive and nonexcessive vs no polypharmacy) were 1.164 (95% CI, 1.142 to 1.186) times that of elderly men. In addition, in the spring season, the odds of polypharmacy were 1.274 (95% CI, 1.241 to 1.309) times that of the winter. Similarly, polypharmacy was strongly higher among patients who had noncommunicable diseases (OR, 2.174; 95% CI, 2.069 to 2.275 (P < 0.001)).
   Conclusion: The high prevalence of hyper prescription in Iran elderly people may indicate a need for interventions aiming at deprescribing drugs with an unfavorable benefit-risk profile. The best practice guidelines should be developed for improved medical practice in the prescription of medications for such a vulnerable population.
Full-Text [PDF 1898 kb]   (392 Downloads)    
Type of Study: Original Research | Subject: Epidemiology

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.