在缺血性中风幸存者中使用二:分析初始过剩供应和纵向趋势
Victor Lomachinsky Torres1, Julianne D Brooks1, Maria A Donahue1
1Department of Neurology (V.L.T., J.D.B., M.A.D., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School, Boston.
Stroke
|October 17, 2024
概括
在缺血性中风后,老年人服用二胺的处方略有下降,但往往包括过量供应. 需要改进处方政策,以确保适当的药物使用和患者安全.
科学领域:
- 老年医学 老年医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 二类药物经常被处方用于急性缺血性中风后的症状,如焦虑和失眠.
- 准则建议不要在65岁及以上的个人中使用二.
- 这一群人群的全国处方模式在很大程度上仍然未被描述.
研究的目的:
- 调查在急性缺血性中风后,在老年人 (≥65岁) 中开始使用二甲的全国模式.
- 分析二甲处方的趋势,包括药物选择,供应持续时间和人口统计学变化.
主要方法:
- 对2013年4月至2021年9月期间20%的美国医疗保险索赔数据样本进行分析.
- 包括65岁以上的受益人,在缺血性中风后活着出院,并连续获得医疗保险A,B和D部分的保险.
- 排除以前曾使用过二,自行出院或出院到熟练护理机构的个人;90天内检查人口统计,并发病症和处方填充数据.
主要成果:
- 在126,050名受益者中,4.9%的人在中风后90天内开始服用二.
- 洛拉泽巴姆 (40%) 和阿尔普拉佐拉姆 (33%) 是最常见的初始处方,其中76%的供应超过7天.
- 开始率在女性 (5.5%) 和美国东南部 (5.1%) 较高,在2013-2021年期间观察到全国范围内的适度下降.
结论:
- 尽管中风后二开药量逐渐下降,但大量的处方涉及过量的药物供应.
- 研究结果强调需要加强处方指南和政策,以优化对老年中风幸存者使用二.
- 进一步研究更安全的替代品和减肥策略是有必要的.
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