Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Analysis of the Use of Medical Institutions and Prescription Drugs for Pulmonary Tuberculosis in Geriatric Patients

노인 폐결핵환자의 의료기관 이용 및 약물사용 분석

  • 문순지 (동덕여자대학교 약학대학) ;
  • 이영숙 (계명대학교 약학대학) ;
  • 유기연 (동덕여자대학교 약학대학)
  • Received : 2018.04.18
  • Accepted : 2018.06.16
  • Published : 2018.06.29
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Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that can affect many organs of the body but usually affects the lungs. The prevalence of TB in Korea is considerably higher than that in other countries with similar economic levels, and is much higher in elderly people. Pharmacotherapy is important in the treatment of TB and requires relatively high compliance for a prolonged duration. Methods: We analyzed sample data of elderly patients obtained from the Health Insurance Review and Assessment Service. We used logistic regression analysis and frequency analysis to identify factors that could affect prevalence of TB in elderly patients, compliance with prescribed medication regimes in these patients, and use of medical institutions. Korean Standard Classification of Diseases, version 7 (KCD-7) was used to diagnose pulmonary TB, and medications were analyzed using Korean standardized drug classification codes. Results: 1,276,331 patients were analyzed in the sample of the elderly population, and 16,658 TB patients were included in the study. The mean age of the TB patients was 76.19 years (SD 6.899). A total of 699 patients were prescribed isoniazid, rifampicin, ethambutol, or pyrazinamide at least once. Of these, 352 (50.4%) were prescribed all four medications and 101 (14.4%) were prescribed only isoniazid, rifampicin, and ethambutol. The mean duration of prescription was 28.75 days (SD 36.13). Conclusion: In the elderly population, old age and poor socioeconomic conditions correlated with TB prevalence. Most patients did not meet the criteria for effective pharmacotherapy of TB.

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References

  1. Dheda K, Barry CE, Maartens G. Tuberculosis. Lancet. 2016; 387:1211-26. https://doi.org/10.1016/S0140-6736(15)00151-8
  2. World Health Organization. Global Tuberculosis Report, 2017. Available from http://apps.who.int/iris/bitstream/10665/259366/1/9789241565516-eng.pdf?ua=1. Accessed March 08, 2018.
  3. Korean Statistical Information Service. TB prevalence by sex and age. Available from http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStats-BoxDiv. Accessed January 05, 2018.
  4. Joint Committee for the Revision of Korean Guidelines for Tuberculosis Korea Centers for Disease Control and Prevention. Korean Guidelines for Tuberculosis, Third Edition, 2017.
  5. Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis 2016;63:e147-95. https://doi.org/10.1093/cid/ciw376
  6. Franke F, Appleton C, Arteaga F, et al. Risk factors and mortality associated with default from multidrug-resistant tuberculosis treatment. Clin Infect Dis 2008;46:1844-51. https://doi.org/10.1086/588292
  7. Chino H, Hagiwara E, Sekine A, et al. Compliance rate of standard treatment regimen and optimal dose of anti-tuberculosis drugs in late elderly patients with pulmonary tuberculosis. Kekkaku 2016;91;495-502.
  8. Velayutham BR, Nair D, Chandrasekaran V, et al. Profile and response to anti-tuberculosis treatment among elderly tuberculosis patients treated under the TB Control programme in South India. PLoS One 2014;9:e88045. https://doi.org/10.1371/journal.pone.0088045
  9. Oshi DC, Oshi SN, Alobu I, et al. Profile and treatment outcomes of tuberculosis in the elderly in southeastern Nigeria, 2011-2012. PLoS One 2014;9:e111910. https://doi.org/10.1371/journal.pone.0111910
  10. Rhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis (Edinb) 2013;93:104-7. https://doi.org/10.1016/j.tube.2012.10.012
  11. Khan MS, Khan MS, Hasan R, et al. Unusual sex differences in tuberculosis notifications across Pakistan and the role of environmental factors. East Mediterr Health J 2013;19:821-5. https://doi.org/10.26719/2013.19.9.821
  12. Fitzgerald DW, Sterling TR. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases, 5th ed. New York, NY: Churchill-Livingstone 2010:3129-64.
  13. Scott C, Kirking HL, Jeffries C, et al. Tuberculosis trends--United States, 2014. MMWR Morb Mortal Wkly Rep 2015;64:265-9
  14. McDonald E, Smith-Palmer A, Wallace LA, et al. Risk factors for TB and HIV coinfection in Scotland, 2001 to 2010. Euro Surveill 2015;20. pii: 21067.
  15. Sun HY, Hsueh PR, Liu WC, et al. Risk of Active Tuberculosis in HIV-Infected Patients in Taiwan with Free Access to HIV Care and a Positive T-Spot.TB Test. PLoS One 2015;10:e0125260. https://doi.org/10.1371/journal.pone.0125260
  16. Sasaki S, Sullivan M, Narvaez CF, et al. Limited efficacy of inactivated influenza vaccine in elderly individuals is associated with decreased production of vaccine-specific antibodies. J Clin Invest 2011;121:3109-19. https://doi.org/10.1172/JCI57834
  17. Gavazzi G, Herrmann F, Krause KH. Aging and infectious diseases in the developing world. Clin Infect Dis 2004;39:83-91. https://doi.org/10.1086/421559
  18. Cruz-Hervert LP, Garcia-Garcia L, Ferreyra-Reyes L, et al. Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes. Age Ageing 2012;41:488-95. https://doi.org/10.1093/ageing/afs028