老年人住院后停止服用抗精神病药物的健康结果
Chun-Ting Yang1, James M Wilkins2, Elyse DiCesare1
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA psychiatry
|May 14, 2025
概括
在老年人住院后停止服用抗精神病药物 (APM) 显著降低了再住院和死亡风险. 早期停止APM治疗对于改善患者的治疗结果和尽量减少该群体的不良事件至关重要.
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:
- 在老年人住院后长期使用抗精神病药物 (APM) 可能会增加不良事件的风险.
- 关于早期停止APM治疗与在出院后继续治疗的比较结果的数据有限.
研究的目的:
- 为了比较在老年人中因住院相关狂妄症而开始的停止和持续的APM之间的临床结果.
- 评估APM停药与再住院,特定不良事件和死亡率的关联.
主要方法:
- 基于人口的队列研究,使用全国性的美国医疗保险索赔和商业医疗保健数据库.
- 包括65岁以上没有先前使用APM的成年人,使用倾向分数 (n=27,424) 进行匹配.
- 分析了包括再住院,妄想,跌倒,尿道感染,肺炎,中风和全因死亡率在内的结果.
主要成果:
- 停用APM与重新住院 (HR,0.89),住院狂妄症 (HR,0.87),与跌倒相关的ED访问/住院 (HR,0.77),以及尿路感染 (HR,0.79) 的风险显著降低.
- 停药也显示所有原因死亡风险明显降低 (HR,0.77).
- 在肺炎或中风风险方面没有观察到显著差异.
结论:
- 在住院治疗后,在老年人中早期停止使用APM与重新住院和死亡风险的降低有关.
- 研究结果强调了尽量减少急性护理后APM持续时间的重要性,以改善患者的治疗结果.
- 结果在各个子组中一致,加强了APM降低处方策略的临床相关性.
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