停用抗精神病药物对长期护理住院风险的影响:基于机器学习的分析
Mikko Nuutinen1,2, Riikka-Leena Leskelä1, Daniela Fialova2,3
1Nordic Healthcare Group, Helsinki, Finland.
BMC medicine
|August 19, 2025
概括
在老年长期护理居民中停止服用抗精神病药物可能会减少12%的住院治疗. 限制使用,年龄和功能障碍等因素会影响这种效果,这表明对大多数用户来说都有好处.
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:
- 抗精神病药物在老年人长期护理设施 (LTCF) 中被广泛使用,尽管已知风险和有效性有限.
- 停用抗精神病药物对这一群体住院风险的影响仍未得到充分研究.
研究的目的:
- 估计抗精神病药物停用对老年LTCF居民住院风险的影响.
- 确定影响抗精神病药物停用对住院治疗影响的因素.
主要方法:
- 基于登记册的回顾性队列研究,对芬兰5467名老年LTCF居民 (2014-2018) 进行了研究.
- 使用全面的老年病评估和医疗保健登记册.
- 应用因果机器学习方法 (DML,DR,X-learner,CF) 来估计治疗效果和解释SHAP值.
主要成果:
- 大约43%的住户停止服用抗精神病药物.
- 停用抗精神病药物与住院概率平均降低12%有关.
- 个体影响各不相同,限制使用,年龄和功能障碍被确定为关键影响因素.
结论:
- 停止服用抗精神病药物可以降低老年LTCF居民住院的可能性.
- 促进抗精神病药物停用可能会减少长期护理机构的住院,发病率和死亡率.
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