养老院使用抗精神病药物的变化对痴呆症居民的结果的影响
Andrew R Zullo1, Melissa R Riester2, Hiren Varma3
1Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Center for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA.
Journal of the American Medical Directors Association
|December 31, 2024
概括
减少在养老院使用抗精神病药物并没有改善痴呆症患者的死亡率或住院治疗. 需要新的策略来有效地管理神经精神病症状.
科学领域:
- 老年学是一门学科.
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 抗精神病药物经常用于痴呆症的养老院居民.
- 全国范围的努力旨在减少这些居民的抗精神病药物使用.
- 这些减排努力对居民结果的影响仍然不清楚.
研究的目的:
- 调查在养老院减少抗精神病药物使用对死亡率和住院率的影响.
- 分析阿尔茨海默氏症和相关痴呆症患者在减少抗精神病药物处方的国家倡议后的结果.
主要方法:
- 一项全国性的观察性研究,模拟使用医疗保险索赔数据的集群随机试验.
- 对比了在养老院减少抗精神病药物使用的结果与维持或增加使用的结果.
- 评估了12个月死亡率,全因住院和特定住院 (中风,心脏病发作,骨折,精神疾病).
主要成果:
- 两组之间死亡率或全因住院没有显著差异.
- 对特定疾病的住院风险也相似.
- 在减少抗精神病药物的设施中,其他精神药物 (抗抑郁药,抗焦虑药,抗药,抗痴呆药) 的使用略有增加.
结论:
- 在养老院减少抗精神病药物的使用似乎没有改善痴呆症居民的死亡率或住院治疗结果.
- 目前仅仅专注于减少抗精神病药物的使用的举措可能不足.
- 开发替代的非药理和药理策略对于管理与痴呆有关的神经精神病症状至关重要.
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