在长期护理设施中居住的老年人中长期使用抗抑郁药
Georgina A Hughes1, Maria C Inacio2, Debra Rowett3
1University of South Australia, UniSA Clinical & Health Sciences, Adelaide, South Australia, Australia; Registry of Senior Australians (ROSA), South Australian Health & Medical Research Institute, Adelaide, South Australia, Australia.
Journal of the American Medical Directors Association
|February 1, 2025
概括
抗抑郁药的使用在长期护理设施 (LTCF) 中很常见,许多居民继续服用药物直到生命结束. 与现有用户相比,新用户的戒断风险更高.
科学领域:
- 老年医学 老年医学
- 心理药理学 心理药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年人经常使用抗抑郁药,在进入长期护理机构 (LTCF) 时使用率增加.
- 有限的数据存在于LTCF入院后抗抑郁药治疗的持续时间.
研究的目的:
- 调查LTCF进入后新用户和现有用户使用抗抑郁药的持续时间.
主要方法:
- 一项回顾性队列研究包括28,426名65-105岁的个人,他们在2015-2018年期间被录取到澳大利亚LTCF.
- 使用累积发病率函数和细灰色回归模型分析了抗抑郁药的使用和停用,并考虑了相应的死亡风险.
- 分配危险比率 (sHR) 被计算出来,以比较新的和现有的抗抑郁药物使用者之间的停药风险.
主要成果:
- 超过78%的住户是现有的抗抑郁药使用者;选择性血清素再吸收抑制剂和米尔塔扎是常见的.
- 36.1%的居民停止服用抗抑郁药,而50.3%的人接受了旨在持续到死亡的处方.
- 新的抗抑郁药使用者与现有使用者相比,停止使用的风险高出36% (aHR,1.36;95% CI,1.29-1.44).
结论:
- 长期使用抗抑郁药在LTCF中很普遍,通常持续到生命末期.
- 尽量减少潜在的不适当使用的策略包括探索非药物替代品和定期的药物审查.
- 确定安全停药的机会至关重要,以减少这种人群的潜在危害.
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