Medication use in nursing home residents with advanced dementia
Medication use in nursing home residents with advanced dementia
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DOI：
10.1002/gps.1921
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发表时间：
2008-05-01
影响因子：
4
通讯作者：
Rabins, Peter V.
中科院分区：
文献类型：
--
作者：
Blass, David M.;Black, Betty S.;Rabins, Peter V.
目的描述养老院晚期痴呆患者的药物使用情况，确定这种使用情况如何随着患者走向死亡而变化，方法前瞻性队列研究（CareAD），采用标准化提取程序，定期从病历中提取处方药数据。在研究入组前6个月内平均处方14.6种药物。在研究期间死亡的患者亚组（n = 88）中，随着死亡时间的临近，处方药物的总数没有变化，但处方药物的类型确实发生了变化，姑息性药物（如阿片类镇痛药）增加，其他药物类别（如抗生素、抗痴呆药、心血管药物和精神药物等）减少。在线性回归分析中，总的药物处方在研究进入与研究网站，抗生素治疗，心血管疾病的存在，和治疗的胃肠道或皮肤病conditions.Conclusions养老院居民与晚期痴呆症规定了大量的药物，从众多的药物类别和处方模式随时间的推移而变化。需要进一步的研究来确定在这一患者群体的生命末期治疗慢性医学问题的理想方法。版权所有（c）2007约翰威利父子有限公司。
Objective To describe medication usage in nursing home residents with advanced dementia, to identify how this usage changed as patients advanced towards death, and to identify correlates of increased medication usage.Methods Prospective cohort study (CareAD) during which data on medication prescription were extracted from medical records at regular intervals using standardized extraction procedures.Results Patients (n = 125) were prescribed a mean of 14.6 medications during the 6 months prior to study enrollment. In a subgroup of patients who died during the study (n = 88), as the time of death approached, the total number of medications prescribed did not vary but the types of medications prescribed did change, with an increase in palliative medications such as opiate analgesics and a decrease in other medication classes such as antibiotics, anti-dementia agents, cardiovascular agents, and psychotropic agents, among others. In linear regression analyses, total medication prescription at study entry was associated with study site, antibiotic treatment, presence of cardiovascular disease, and treatment of gastrointestinal or dermatological conditions.Conclusions Nursing home residents with advanced dementia are prescribed a large number of medications from numerous medication classes and prescribing patterns change over time. Further study is needed to determine the ideal approach to treating chronic medical problems at the end of life in this patient population. Copyright (c) 2007 John Wiley & Sons, Ltd.