老年退伍军人的中枢神经系统活性处方:流行趋势,处方者和高风险人群的趋势

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Robert E Burke^1,2,3, Lindsay Pelcher⁴, Andrew Tjader⁴

¹Center for Health Equity Research and Promotion, Corporal Crescenz VA Medical Center, Philadelphia, PA, USA. Robert.Burke2@pennmedicine.upenn.edu.

Journal of general internal medicine

|June 22, 2023

概括

老年退伍军人中中枢神经系统活性药物的处方增加,特别是 gabapentinoids,而阿片类药物的使用减少. 高风险组显示中枢神经系统活性多药性升高,VA处方的慢性性更大.

科学领域:

老年人药房老年人药房
医疗保健服务研究医疗服务研究
药物监督药物监督药物监督

背景情况:

对老年退伍军人中使用中枢神经系统活性 (CNS活性) 药物的理解有限.
需要在这个人群中描述中枢神经系统活性处方的流行率和慢性.

研究的目的:

描述老年退伍军人中中枢神经系统活性药物处方的趋势.
分析高风险子组的处方变化.
为了确定处方的来源 (VA与医疗保险D部分).

主要方法:

对65岁以上退伍军人的回顾性队列研究 (2015-2019)
包括在医疗保险和VA注册的退伍军人,居住在VISN 4.
分析的药物类别:抗精神病药物, gabapentinoids,肌肉松剂,阿片类药物,镇静催眠药,抗胆固醇药.

主要成果:

gabapentinoid 的患病率和慢性显著增加,而阿片类药物和镇静剂-催眠药的使用减少.
高风险群体 (痴呆症,高利用率,虚弱) 的中枢神经系统活性多药率是中枢神经系统活性多药的两倍.
在医疗保险D部分中,阿片类药物/镇静剂-催眠药的流行率更高;在VA处方中,大多数中枢神经系统活性药物的慢性性更大.

结论:

随着 gabapentinoid 处方的增加以及阿片类药物/镇静剂-催眠剂使用的减少,需要对安全结果进行评估.
在高风险的老年退伍军人中,有显著的机会降低中枢神经系统活性药物的处方.
越来越多的VA处方需要进一步研究其机制和对双重使用者的影响.

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