一项养老院临床医生调查解释了 gabapentinoid 的增加
Jonathan D Winter1, J William Kerns1, Danya M Qato2
1Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Shenandoah Valley Family Practice Residency, Front Royal, VA, USA.
Journal of the American Medical Directors Association
|November 20, 2024
概括
养老院的临床医生很少对 gabapentinoids 进行处方,通常认为它们比阿片类药物更安全. 在所有护理环境中优先考虑 gabapentinoid 剂量减少对于提高养老院安全至关重要.
科学领域:
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 在养老院 (NHs) 中, gabapentinoid 的处方正在增加.
- 了解临床医生对 gabapentinoid 使用和减记的看法对于改善 NH 护理至关重要.
- 许多 gabapentinoid 处方来源于NHs之外,这复杂化了抑郁症的处方工作.
研究的目的:
- 调查NH临床医生关于 gabapentinoid 的处方指示.
- 为了确定驱动NHs增加 gabapentinoid使用的因素.
- 为了探索临床医生对 gabapentinoid 抑郁症的经验.
主要方法:
- 一项匿名在线调查被分发给美国的NH处方医生.
- 调查招聘利用了通过NH临床医生组织的众包.
- 该调查工具由一个多学科团队开发,专注于规定模式,指示和描述经验.
主要成果:
- 大多数 gabapentinoids 是在NHs之外开始的,通常是针对疼痛的非标签.
- 临床医生认为 gabapentinoids 对心理行为症状有用,特别是当与疼痛同时发生时.
- 处方不频繁且不优先;临床医生认为 gabapentinoids 比阿片类药物,二类药物和抗精神病药物更安全.
结论:
- 有机会通过优先考虑逐步降低 gabapentinoid 剂量来提高 NH 安全性.
- 减少 gabapentinoid 使用的努力必须涵盖所有护理环境,因为外部处方来源.
- 将 gabapentinoids 纳入 NH 精神药物指令可以提高安全性,并解决缺乏非标签适用的疗效数据的问题.
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