中枢神经系统药物在住院期间使用
Juliessa M Pavon1,2,3,4, Richard J Sloane2,3,4, Cathleen S Colón-Emeric1,2,3,4
1Department of Medicine/Division of Geriatrics, Duke University, Durham, North Carolina, USA.
Journal of the American Geriatrics Society
|April 11, 2024
概括
在住院期间,大多数老年人中,中枢神经系统 (CNS) 药物使用保持稳定. 然而,一些患者,特别是那些服用止痛药的人,可能会在入院和出院之间停止使用中枢神经系统药物.
科学领域:
- 老年人药理学 老年人药理学
- 医疗保健服务研究 医疗服务研究
- 临床药房 临床药房
背景情况:
- 中枢神经系统 (CNS) 药物使用在老年人中普遍存在.
- 住院治疗对中枢神经系统药物治疗方案的影响尚不清楚.
- 这项研究调查了在住院期间的中枢神经系统药物使用模式和用户个人资料.
研究的目的:
- 分析中枢神经系统药物使用,停药以及老年人住院期间的使用情况.
- 根据中枢神经系统药物使用在不同时间点识别不同的患者个人资料.
- 检查在住院期间影响中枢神经系统药物使用情况之间的转变的因素.
主要方法:
- 65岁及以上患者的回顾性队列研究,使用电子健康记录 (2018-2020年).
- 从入院前90天到入院后90天的中枢神经系统药物使用情况分析.
- 隐藏类过渡分析 (LCTA) 用于识别四个时间点的用户配置文件和过渡.
主要成果:
- 抗抑郁药 (56%) 和阿片类药物 (49%) 是最常见的中枢神经系统药物.
- 74%的患者是持续使用者;7%在住院期间停止了中枢神经系统药物治疗,64%在出院后90天内重新开始使用.
- 确定了三个主要的用户配置文件:中枢神经系统低使用者 (54-60%),心理健康用户 (30-36%),和止痛药使用者 (9-10%).
- 停药在入院和出院之间更有可能发生,特别是对于止痛药使用者 (9%的概率).
- 女性性别增加了几率,而慢性病减少了在入院和出院之间过渡到低中枢神经系统使用的几率.
结论:
- 中枢神经系统药物使用通常在住院期间对老年人保持一致.
- 停用中枢神经系统药物更有可能发生在离院期间,特别是对于服用止痛药的人来说.
- 需要进一步的研究来评估医院脱处方的结果,特别是对于需要逐渐逐渐减少的药物.
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