Nursing home resources and tranquilizer use among the institutionalized elderly.
Nursing home resources and tranquilizer use among the institutionalized elderly.
复制标题
疗养院资源和住院老年人的镇定剂使用情况。
DOI：
10.1111/j.1532-5415.1991.tb04453.x
复制
发表时间：
1991
影响因子：
6.3
通讯作者：
Mount,JK
中科院分区：
文献类型：
--
作者：
Svarstad,BL;Mount,JK
目标。目的探讨在专业护理机构中，选定的住院医师和设施特征与镇定剂处方和使用的频率和质量之间的关系。使用标准化协议设置对药物概况和药房计费记录进行回顾性审查。七家专业护理机构。所有65岁或以上的居民都有资格。760名居民或监护人表示同意。6人拒绝许可。结果的措施。药物使用情况包括是否有镇静剂订单，过去30天内是否使用过镇静剂，以及是否偏离所选的药物使用标准。在760名居民中，38%的人服用了抗精神病药或抗焦虑药，28%的人实际上服用了镇定剂。将镇定剂使用与特定药物使用标准进行比较表明，近19%的老年居民暴露于某种类型的过度使用，如长时间使用、多种药物使用或重复治疗。在人员配备和其他资源不足的设施中，居民更有可能获得镇静剂订单，使用镇静剂，并偏离药物使用标准。数据还显示，在被诊断为精神障碍的居民、年轻居民和医疗补助接受者中，偏离标准的比例更高。必须更多地关注环境因素，这些因素可能会破坏目前在熟练护理机构中改善精神药物处方和使用的努力。
Objective. To examine the relationship between selected resident and facility characteristics and the frequency and quality of tranquilizer prescribing and use in skilled nursing facilities.Design. Retrospective review of medication profiles and pharmacy billing records using standardized protocol.Settings. Seven skilled nursing facilities.Participants. All residents aged 65 years or older were eligible. Consent was given by 760 residents or guardians. Six refused permission.Outcome Measures. Drug use measures included the presence or absence of a tranquilizer order, any tranquilizer use during previous 30 days, and any deviation from selected drug use criteria.Results. Of 760 residents, 38% had an order for an antipsychotic or antianxiety agent, and 28% actually received a tranquilizer. Comparing tranquilizer practices with specific drug‐use criteria showed that nearly 19% of all elderly residents were exposed to some type of excess use such as long duration, polymedicine, or therapeutic duplication. Residents in facilities with less adequate staffing and other resources were significantly more likely to have a tranquilizer order, to have a tranquilizer administered, and to have any deviation from drug‐use criteria. The data also show higher rates of deviation from criteria among residents with a diagnosed mental disorder, younger residents, and Medicaid recipients.Conclusion. More attention must be paid to environmental factors that may undermine current efforts to improve psychotropic drug prescribing and use in skilled nursing facilities.