发生痴呆症诊断后长期药物使用的变化
Timothy S Anderson1,2, John Z Ayanian3,4, Vilsa E Curto5
1Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
JAMA internal medicine
|August 21, 2023
概括
在被诊断患有痴呆症后,老年人增加了药物使用,特别是中枢神经系统活性药物,并减少了心脏代谢和抗胆固醇药物的使用. 这突显了多药店潜在的风险,并描述了痴呆症护理中的机会.
科学领域:
- 老年学和老年医学是老年学和老年医学.
- 神经科学和神经病学 神经科学和神经病学
- 药理学和制药科学 药理学和制药科学
背景情况:
- 痴呆症诊断显著影响老年人的药物管理和慢性疾病护理.
- 了解诊断后的药物使用变化对于患者的安全性和治疗疗效至关重要.
研究的目的:
- 在社区居住的老年人中,在发生痴呆症诊断后,调查药物使用模式的变化.
- 分析药物总数和特定药物类别的变化,包括心脏代谢药物,中枢神经系统活性药物和抗胆固醇药物.
主要方法:
- 一项包括在医疗保险中注册的67岁以上成年人的队列研究,在2012-2018年期间诊断出患有痴呆症的事件.
- 痴呆症患者与对照者匹配;比较时间序列分析检查了季度药物使用变化和诊断前后的变化.
- 结果包括整体药物计数和心脏代谢药物,中枢神经系统活性药物和抗胆固醇药物的使用.
主要成果:
- 痴呆症队列的平均药物数量 (+0.41) 和中枢神经系统活性药物使用量 (+3.44%) 增加得更大,主要是抗精神病药物,抗抑郁药物和抗药.
- 在痴呆症组中观察到抗胆固醇和心脏代谢药物停用率的适度增加.
- 诊断后一年,75.2%的痴呆症患者正在使用五种或更多种药物.
结论:
- 在被诊断为痴呆症后,患者更有可能开始服用中枢神经系统活性药物,并停止服用其他药物,这表明潜在的多药和抑郁症的挑战.
- 研究结果表明,在老年痴呆症患者中,错失了减少药物负担和相关风险的机会.
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