心理社会干预措施,以减少护理院居民服用抗精神病药物
Julia Lühnen1,2, Tanja Richter3, Stella Calo4
1Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
The Cochrane database of systematic reviews
|August 31, 2023
概括
对患有痴呆症的养老院居民的心理社会干预措施对减少抗精神病药物使用产生不确定的影响. 虽然一些研究表明有好处,但总体证据的确定性很低,对跌倒或住院没有重大影响.
科学领域:
- 老年学和老年医学是老年学和老年医学.
- 精神病学和心理健康 精神病学和心理健康
- 基于证据的实践.
背景情况:
- 抗精神病药物经常被处方治疗痴呆症的行为和心理症状 (BPSD) 在养老院,尽管对疗效和不良影响的担忧.
- 针对住户或工作人员的心理社会干预措施可用于减少抗精神病药物处方.
- 本综述更新了2012年对心理社会干预措施的分析,旨在减少这一群体中抗精神病药物的使用.
研究的目的:
- 评估心理社会干预措施的益处和危害,以减少养老院居民的抗精神病药物使用.
- 将这些干预措施与常规护理,优化护理或其他心理社会方法进行比较.
主要方法:
- 包括五个集群随机对照试验 (120个集群,8342名参与者) 通过全面的Cochrane搜索确定到2022年7月.
- 专注于具有人际关系组成部分的非药物心理社会干预,不包括停用药物或基于政策的变化.
- 评估主要结果,包括抗精神病药物使用和二次结果,如死亡率,BPSD,生活质量和不良事件.
主要成果:
- 研究中的显著临床异质性导致了对结果的叙述性陈述;减少抗精神病药物使用的证据的整体确定性很低.
- 一项研究表明,通过对工作人员的教育干预,减少了抗精神病药物的使用 (每100个住院日的日数).
- 对于其他干预措施,观察到不同的结果;高确定性证据显示在跌倒,住院或急诊访问方面几乎没有差异. 中等到低确定性证据表明,对生活质量,BPSD或其他次要结果没有重大影响,尽管社会相互作用和药物审查显示了降低死亡率的潜力.
结论:
- 包括的干预措施是复杂的和可变的描述,限制了概括性.
- 有限的证据表明,复杂的心理社会干预和药物审查可能会减少抗精神病药物的使用.
- 目前的证据基础不支持对心理社会干预措施的明确,可概括的建议,以减少在养老院处方抗精神病药物.
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