在社区居住的痴呆症患者中滥用和过度使用药物
W James Deardorff1,2, Bocheng Jing1,2, Matthew E Growdon1,2
1Division of Geriatrics, University of California, San Francisco, San Francisco, California, USA.
Journal of the American Geriatrics Society
|June 5, 2023
概括
痴呆症患者 (PWD) 经常服用多种药物,其中73%的人接受了可能有问题的处方. 停止处方不仅应针对影响认知能力的药物,还应针对PPI和NSAID来改善PWD护理.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 多药在痴呆症患者 (PWD) 中普遍存在.
- 以前的研究集中在PWD的特定药物问题上.
- 这项研究旨在广泛描述社区住户PWD的药物滥用和过度使用.
研究的目的:
- 为了识别和量化药物滥用和过度使用在社区生活PWD的频谱.
- 将PWD患者的有问题的药物使用与没有痴呆症的匹配队列进行比较.
- 为了告知PWD的抑郁症描述策略.
主要方法:
- 利用了与Medicare相关的健康和退休研究 (2008-2018) 的数据,用于年龄≥66.6岁的成年人.
- 使用经过验证的算法确定痴呆症.
- 通过过度使用 (例如,积极的糖尿病/高血压治疗,终生不适合) 和滥用 (例如,认知损害药物,酒/STOPP标准) 定义的潜在问题药物.
- 雇员倾向-得分匹配,将PWD与没有痴呆症的个人比较.
- 应用调查权重来衡量国家代表性.
主要成果:
- 在1441名残疾人中,73%的人至少服用了一种可能有问题的药物,平均每人2.09分.
- 41%的PWD被处方药物已知负面影响认知.
- 常见的问题药物包括质子抑制剂 (PPI),NSAID,阿片类药物,抗高血压药和抗糖尿病药物.
- 与对照组 (67%) 相比,PWD有更高的问题药物使用率 (73%).
结论:
- 居住在社区的PWD经常经历各种类别的有问题的药物使用.
- 问题性药物使用在PWD中比在没有痴呆症的人中更常见.
- 对PWD的禁用计划应该针对中枢神经系统活性药物,PPI和NSAID.
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