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Medical Journal of Islamic Republic of Iran، جلد ۳۵، شماره ۱، صفحات ۱۱۹۰-۱۲۰۱
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عنوان انگلیسی Mapping Drug Prescription, Polypharmacy, and Pharmaceutical Spending in Older Adults in Iran: A Multilevel Analysis Based on Claims Data
چکیده انگلیسی مقاله 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.
کلیدواژه‌های انگلیسی مقاله Drug Prescription, Polypharmacy, Pharmaceutical Spending, Multilevel, Claim Data
نویسندگان مقاله | Naser Kamyari
Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran


| Ali Reza Soltanian
Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran


| Hossein Mahjub
Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran


| Abbas Moghimbeigi
4. Department of Biostatistics and Epidemiology, School of Health & Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran


| Zahra Shahali
National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
نشانی اینترنتی http://mjiri.iums.ac.ir/browse.php?a_code=A-10-6785-1&slc_lang=en&sid=1
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کد مقاله (doi)
زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده Epidemiology
نوع مقاله منتشر شده Original Research
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