在住院治疗后,在老年人中停止使用二胺的模式和相关因素
Chun-Ting Yang1, James M Wilkins2, Kevin T Pritchard1
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American Geriatrics Society
|July 27, 2025
概括
在住院治疗后,老年人中佐地亚 (BZD) 停药率有所增加. 然而,对于那些患有失眠和虚弱的人来说,停止服用BZD仍然具有挑战性,这凸显了针对性抑郁症策略的需要.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 老年人住院后长期使用二 (BZD) 会增加依赖性和不良事件.
- 了解BZD戒断模式和影响因素在这个人口是有限的.
研究的目的:
- 分析医院出院后老年人中的二二类药物停药率和相关因素.
- 为了识别患者的特征,阻碍或促进BZD脱.
主要方法:
- 使用Optum CDM (2004-2025) 对65岁以上的患者进行回顾性队列研究,这些患者在住院后开始患有BZD.
- 卡普兰-梅尔方法用于戒断率; 考克斯比例危险模型用于因子分析,对死亡风险竞争的审查权重的反向概率.
- 排除标准包括焦虑,精神疾病,滥用酒精,发作障碍和临终关怀.
主要成果:
- 30日,60日和90天的BZD停药率分别为53.3%,86.7%和92.6%.
- 从2004年到2024年,观察到30天停药率每年显著增加4%.
- 较低停药与失眠 (HR:0.66),中度至严重的虚弱 (HR:0.82),以及新使用抗抑郁药物 (HR:0.80) 或非典型抗精神病药物 (HR:0.90) 相关.
结论:
- 在没有先前精神病史的老年人中,佐地亚类药物停用率在住院后有所上升.
- 失眠和中度至重度的虚弱性对停止BZD治疗构成重大障碍.
- 这些患者群体代表了未来二二类药物停止处方干预措施的关键目标.
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