Eight-Year Trends in the Use of Opioids, Other Analgesics, and Psychotropic Medications Among Institutionalized Older People in Finland
Eight-Year Trends in the Use of Opioids, Other Analgesics, and Psychotropic Medications Among Institutionalized Older People in Finland
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DOI：
10.1016/j.jamda.2015.06.009
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发表时间：
2015-11-01
影响因子：
7.6
通讯作者：
Bell, J. Simon
中科院分区：
文献类型：
--
作者：
Pitkala, Kaisu H.;Juola, Anna-Liisa;Bell, J. Simon
重要性：它是公认的，疼痛一直治疗不足和精神药物过度使用在institutional settings.Objective：调查阿片类药物，其他镇痛药，和精神药物的流行率的变化在机构设置在8年期间。2003年养老院的老年居民（n = 1987）和2011年（n = 1576）和辅助生活设施，2007年（n = 1377）和2011年（n = 1586）。结果测量：在8年的3个时间点在机构化居民中进行药物使用的可比审计。定期阿片类药物，其他镇痛药和精神药物的患病率进行了比较，在3个时间periods.Results：养老院和辅助生活设施的居民年龄较大，更多的残疾，有较高的患病率痴呆症，更大的comorbidity在后者的队列。2003年和2011年，护理院经常使用阿片类药物的患病率分别为11.8%和22.9%（P < .001），2007年和2011年辅助生活设施的患病率分别为8.6%和17.3%（P < .001）。在疗养院和辅助生活设施中，常规对乙酰氨基酚和普瑞巴林/加巴喷丁的患病率增加，NSAID减少。在疗养院中，定期使用抗精神病药物的患病率从42.6%下降到27.8%（P <0.001），但在辅助生活设施中从26.9%上升到32.0%（P = 0.0017）。在疗养院中，每位居民平均使用精神药物（抗精神病药、抗抑郁药、抗焦虑药、催眠药）的数量从2003年的1.9种下降到2011年的1.0种（P
Importance: It is recognized that pain has been undertreated and psychotropic medications overused in institutional settings.Objective: To investigate the change in prevalence of opioids, other analgesics, and psychotropic medications in institutional settings over an 8-year period.Settings: Institutional settings in Helsinki, Finland.Participants: Older residents in nursing homes in 2003 (n = 1987) and 2011 (n = 1576) and in assisted living facilities in 2007 (n = 1377) and 2011 (n = 1586).Outcome Measures: Comparable audits of medication use were conducted among institutionalized residents at 3 time points over 8 years. The prevalence of regular opioid, other analgesic, and psychotropic medications was compared across the 3 time periods.Results: Nursing home and assisted living facility residents were older; more disabled, had a higher prevalence of dementia, and greater comorbidity in the latter cohorts. The prevalence of regular opioid use was 11.8% and 22.9% in nursinghomes in 2003 and 2011 (P < .001), and 8.6% and 17.3% in assisted living facilities in 2007 and 2011 (P < .001), respectively. The prevalence of regular acetaminophen and pregabalin/gabapentin increased and NSAIDs decreased in both nursing homes and assisted living facilities. The prevalence of regular antipsychotic use decreased from 42.6% to 27.8% in nursing homes (P < .001) but increased from 26.9% to 32.0% in assisted living facilities (P = .0017). The mean number of psychotropic medications (antipsychotics, antidepressants, anxiolytics, hypnotics) per resident decreased from 1.9 in 2003 to 1.0 in 2011 in nursing homes (P