Exposure to psychotropics in the French older population living with dementia: a nationwide population-based study
Exposure to psychotropics in the French older population living with dementia: a nationwide population-based study
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DOI：
10.1002/gps.4517
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发表时间：
2017-07-01
影响因子：
4
通讯作者：
Leperre-Desplanques, Armelle
中科院分区：
文献类型：
--
作者：
Breining, Alice;Bonnet-Zamponi, Dominique;Leperre-Desplanques, Armelle
背景对痴呆患者的精神药物慢性暴露水平知之甚少。这项研究的目的是量化慢性精神药物暴露在老年痴呆症与一般人群相比，同一age.MethodsThis前瞻性队列研究在法国进行2009年和2011年之间。年龄至少65岁，10，781，812人（其中440，215人患有痴呆症），包括社区居民或养老院居民。测量了每年抗精神病药、抗抑郁药、抗焦虑药或催眠药的单一或联合处方数量。结果在痴呆症患者中，15.5%的患者接触过抗精神病药，而年龄匹配人群的这一比例为2.2%（相对风险[RR]=6.44，95%置信区间[CI] [6.39-6.48]），抗抑郁药组为39.5%，对照组为12.6%（RR=4.10，95% CI [.4.07-4.12]），抗焦虑药或催眠药组为39.6%，而抗焦虑药或催眠药组为26.9%（RR=1.74，95% CI [1.72-1.75]）。在老年痴呆症患者中，13.8%的人同时服用至少三种精神药物。除长效苯二氮卓类药物外，所有年龄段的老年痴呆患者更多地暴露于所有精神药物。在研究期间，慢性抗焦虑/催眠药和抗精神病药物的暴露略有下降，在人口与痴呆症，而慢性暴露于抗抑郁药物往往increasing.ConclusionThis全国范围内，人口为基础的，药物使用的研究首次表明，老年痴呆症患者长期过度不仅抗精神病药物，但也精神药物。
BackgroundLittle is known about the level of psychotropic chronic exposure in all patients living with dementia. The aim of the study was to quantify chronic psychotropic exposure in older adults with dementia compared with the general population of the same age.MethodsThis prospective cohort study was conducted in France between 2009 and 2011. Aged at least 65years, 10,781,812 individuals (440,215 of them with dementia) either community based or nursing home residents were included. The numbers of single or combined prescriptions, per year for antipsychotics, antidepressants, anxiolytics, or hypnotics were measured.ResultsOf patients with dementia, 15.5% are exposed to antipsychotics compared with 2.2% of the age-matched population (relative risk [RR]=6.44, 95% confidence interval [CI] [6.39-6.48]), 39.5% to antidepressants compared with 12.6% (RR=4.10, 95% CI [.4.07-4.12]), and 39.6% to anxiolytics or hypnotics compared with 26.9% (RR=1.74, 95% CI [1.72-1.75]). Among older adults with dementia, 13.8% simultaneously consumed at least three psychotropics. All class age of older patients with dementia is more exposed to all psychotropics except for long-acting benzodiazepines. During the study period, chronic anxiolytic/hypnotic and antipsychotic exposure slightly decreased in population with dementia while chronic exposure to antidepressant drugs tended to increase.ConclusionThis nationwide, population-based, drug-used study showed for the first time that older patients with dementia are chronically overexposed not only to antipsychotics but also to psychotropics.