探索在一个全面的痴呆症护理计划中,在患有痴呆症的人群中启动抗精神病治疗
David R Lee1, Grace Sassana-Khadka2, Tahmineh Romero3
1Multicampus Program in Geriatric Medicine and Gerontology, Division of Geriatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA.
Journal of the American Geriatrics Society
|June 9, 2025
概括
在痴呆症护理中开始服用抗精神病药物 (APM) 是常见的,即使有非药物选择. 较高的症状严重程度和痛苦与APM使用相关,影响生存结果.
科学领域:
- 老年学是一门学科.
- 精神病学是一个精神病学.
- 临床药房 临床药房
背景情况:
- 抗精神病药物 (APM) 经常被处方给痴呆症患者,尽管有证据表明益处有限,风险增加.
- 这项研究调查了患者的特征,APM启动的原因以及该人群的生存结果.
研究的目的:
- 检查与在痴呆症护理计划中开始服用抗精神病药物 (APM) 相关的患者特征.
- 为了确定APM启动的指示.
- 分析与APM使用相关的生存结果.
主要方法:
- 在痴呆症护理计划中社区住宿患者的回顾性队列研究 (2012-2014).
- 生存分析包括190名患者在基线时没有服用APM,200名患者在进入时服用APM,在开始时长达2年和死亡率至2024年进行随访.
- 后勤回归和Cox比例危险模型被用于分析基线特征,APM启动和生存.
主要成果:
- 在190名不使用APM的患者中,34%的患者开始使用APM. 高级神经精神病学清单问卷 (NPI-Q) 严重程度和痛苦得分与APM启动有关.
- 兴奋和精神病症状是主要的征兆;奎平是最常被处方的APM.
- 平均存活时间有显著差异:基线APM使用者为37.8个月,发起者为63.1个月,非发起者为68.9个月 (p < 0.001).
结论:
- 在强调非药物治疗方法的痴呆症护理计划中,APM启动很普遍.
- 观察到的生存差异凸显了关于APM的全面风险-收益讨论和与护理人员分享关于护理目标的决策的关键需求.
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