在DEmentia中减少抗精神病药物的处方和护理 (DECADE) - 一项混合有效性实施试点研究
Hanne Birke1, Sidsel Maria Jørgensen1, Laura Victoria Jedig Lech2
1Center for Clinical Research and Prevention (HB, SMJ, MLS), Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
概括
DECADE干预措施成功地减少了痴呆症的养老院居民对抗精神病药物的使用. 这种方法改善了护理,而没有恶化行为症状或增加其他精神药物.
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 实施 科学 科学
背景情况:
- 抗精神病药物的使用在痴呆症的养老院居民中很常见.
- 减少抗精神病药物的使用是减轻相关风险的优先事项.
- 在DEprescribing and Care to reduce Antipsychotics in Dementia (DECADE) 的研究中,我们已经解决了这一问题.
研究的目的:
- 评估一项多方面的干预措施,以减少痴呆症患者使用抗精神病药物.
- 评估干预措施是否可以避免药物转移或恶化痴呆症行为和心理症状 (BPSD).
主要方法:
- 一个2型混合有效性实施试点研究在六个丹麦养老院.
- 干预包括40名居民的教育,药物审查和个性化护理计划.
- 收集了关于实施忠实度,抗精神病药物/精神药物使用和BPSD分数的数据.
主要成果:
- 实施忠实度高,但教育参与度低.
- 抗精神病药物使用的显著减少 (平均每日减少1.1毫克 olanzapine 等效).
- 36%的住户实现了≥50%的减轻,而没有增加心理药物使用或恶化BPSD.
结论:
- 十年的干预有效地减少了痴呆症患者的抗精神病药物的使用.
- 这种方法并没有使BPSD恶化,也没有导致药物转换.
- 多学科的合作和教育对于成功的戒药至关重要.
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