在同时接受抗痴呆药物和潜在危险药物的医疗保险受益者中,跌倒和骨折
Nancy E Morden1,2, Deanna Chyn1, Ellen Meara1,3,4
1The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH.
Medical care
|October 27, 2025
概括
与痴呆症药物同时使用阿片类药物显著增加了老年人的跌倒风险,特别是长期护理者. 减少可避免的阿片类药物处方可以预防阿尔茨海默病和相关痴呆症 (ADRD) 患者的不良事件和痛苦.
科学领域:
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 患有阿尔茨海默氏症和相关痴呆症 (ADRD) 的患者面临潜在不合适药物的风险.
- 同时使用抗痴呆药物可能会放大与这些药物相关的风险.
研究的目的:
- 为了调查同时接受抗痴呆和潜在危险药物的老年人不良事件.
- 评估同时使用药物与诸如跌倒,关节骨折和死亡等不良事件之间的联系.
主要方法:
- 利用了2016-2019年医疗保险从收费服务受益人的行政数据.
- 确定的同时接受抗痴呆药物 (乙胆酶抑制剂 (AChEI) 和/或记忆剂) 与危险药物 (二胺,镇静催眠药,阿片类药物).
- 对长期护理 (LTC) 住所进行分层回归分析,以测量跌倒,关节骨折和死亡.
主要成果:
- 研究了633528名受益者;64.3%是女性,平均年龄为80.9岁.
- 同时接受ACHEI和阿片类药物显示最大的跌倒风险增加 (社区HR2.25,LTC1.46).
- 跌倒是最常见的结果,影响了22.5%的受益人.
结论:
- 同时使用阿片类药物和痴呆症药物并不常见,但似乎有风险.
- 减少可避免的阿片类药物使用的努力可以减少ADRD患者的不良事件和痛苦.
- 在ADRD患者中管理复杂的药物治疗方案需要仔细评估.
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