Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care units
Inappropriate long-term use of antipsychotic drugs is common among people with dementia living in specialized care units
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DOI：
10.1186/2050-6511-14-10
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发表时间：
2013-02-08
影响因子：
2.9
通讯作者：
Lovheim, Hugo
中科院分区：
文献类型：
--
作者：
Gustafsson, Maria;Karlsson, Stig;Lovheim, Hugo
背景：抗精神病药物被广泛用于治疗痴呆的行为和心理症状(BPSD)，尽管其疗效有限且安全性令人担忧。本研究的目的是描述居住在瑞典北部专门护理病房的痴呆症患者的抗精神病药物治疗。方法：这项研究在瑞典北部的40个专门护理病房进行，研究对象为344名痴呆症患者。使用多维痴呆评估量表(MDDAS)对研究人群的抗精神病药物使用、ADL功能、认知功能和BPSD进行描述。这些数据是在基线和六个月后收集的。从处方记录中收集有关抗精神病药物处方的详细数据。结果：这项研究显示，在研究人群中，132人(38%)在研究开始时使用抗精神病药物。其中，52/132(39%)的处方在剂量和物质方面遵循国家指南。六个月后，132人中有111人因死亡和辍学而离开。在这111人中，80人(72%)仍在接受抗精神病药物治疗，63/111人(57%)仍在接受相同剂量的治疗。表现出攻击性行为(OR：1.980，CI：1.515~2.588)、被动(OR：1.548，CI：1.150~2.083)或有轻度认知障碍(OR：2.284，CI：1.046~4.988)的患者服用抗精神病药物的风险增加。结论：居住在专科病房的痴呆患者抗精神病药物的使用率较高，且长期不适当地使用抗精神病药物的情况很常见。
Background: Antipsychotic drugs are widely used for the treatment of Behavioral and Psychological Symptoms of Dementia (BPSD), despite their limited efficacy and concerns about safety. The aim of this study was to describe antipsychotic drug therapy among people with dementia living in specialized care units in northern Sweden.Methods: This study was conducted in 40 specialized care units in northern Sweden, with a total study population of 344 people with dementia. The study population was described in regard to antipsychotic drug use, ADL function, cognitive function and BPSD, using the Multi-Dimensional Dementia Assessment Scale (MDDAS). These data were collected at baseline and six months later. Detailed data about antipsychotic prescribing were collected from prescription records.Results: This study showed that 132 persons (38%) in the study population used antipsychotic drugs at the start of the study. Of these, 52/132 (39%) had prescriptions that followed national guidelines with regard to dose and substance. After six months, there were 111 of 132 persons left because of deaths and dropouts. Of these 111 people, 80 (72%) were still being treated with antipsychotics, 63/111 (57%) with the same dose. People who exhibited aggressive behavior (OR: 1.980, CI: 1.515-2.588), or passiveness (OR: 1.548, CI: 1.150-2.083), or had mild cognitive impairment (OR: 2.284 CI: 1.046-4.988), were at increased risk of being prescribed antipsychotics.Conclusion: The prevalence of antipsychotic drug use among people with dementia living in specialized care units was high and inappropriate long-term use of antipsychotic drugs was common.