Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1399
10
1
gregorian
2021
1
1
35
1
online
1
fulltext
en
Mapping Drug Prescription, Polypharmacy, and Pharmaceutical Spending in Older Adults in Iran: A Multilevel Analysis Based on Claims Data
Epidemiology
Epidemiology
Original Research
Original Research
<strong>Background: </strong>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.<br>
<strong>Methods:</strong> 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%.<br>
<strong>Results:</strong> 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)).<br>
<strong>Conclusion:</strong> 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.
Drug Prescription, Polypharmacy, Pharmaceutical Spending, Multilevel, Claim Data
1190
1201
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6785-1&slc_lang=en&sid=1
Naser
Kamyari
n.kamyari@yahoo.com
200319475328460066829
200319475328460066829
No
Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Ali Reza
Soltanian
soltanian@umsha.ac.ir
200319475328460066830
200319475328460066830
Yes
Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
Hossein
Mahjub
mahjub@umsha.ac.ir
200319475328460066831
200319475328460066831
No
Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Abbas
Moghimbeigi
moghimb@yahoo.com
200319475328460066832
200319475328460066832
No
4. Department of Biostatistics and Epidemiology, School of Health & Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
Zahra
Shahali
z.shahali3000@ihio.gov.ir
200319475328460066833
200319475328460066833
No
National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran