Psychotropic Drug Prescription and the Risk of Falls in Nursing Home Residents
Psychotropic Drug Prescription and the Risk of Falls in Nursing Home Residents
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DOI：
10.1016/j.jamda.2016.07.004
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发表时间：
2016-12-01
影响因子：
7.6
通讯作者：
van der Linden, Carolien M. J.
中科院分区：
文献类型：
--
作者：
Cox, Claudia A.;van Jaarsveld, Heike J.;van der Linden, Carolien M. J.
背景：跌倒是老年人常见且严重的问题。先前的研究表明，使用精神药物会增加跌倒的风险。然而，到目前为止，这些药物对跌倒风险的贡献还没有在养老院的普通人群中每天进行量化。目的：评估普通养老院人群中精神药物及不同类别精神药物（抗精神病药、抗抑郁药和苯二氮卓类药物）处方与跌倒发生率的关系。设计：回顾性观察性研究，数据收集/人/日。背景：荷兰埃因霍温的9家养老院。研究对象：2368名疗养院居民，共538,575人次/天。主要结局指标：精神药物处方与跌倒之间的关系。结果：共纳入2368名养老院居民，数据集为538,575人次/天。共318128人次日（59.1%）每天至少开具1种精神药物处方。有或没有按需处方的计划处方共涉及270,781人日（50.3%）。定期开具精神药物处方与跌倒发生率增加近3倍相关（OR 2.88; 95% CI 1.52-5.44）。服用抗精神病药（OR 1.97; 95% CI 1.51-2.59）和抗抑郁药（OR 2.26; 95% CI 1.73-2.95）后，跌倒发生率增加。在定期处方和按需处方中都发现了这种增加的跌倒风险。结论：精神药物处方与养老院居民跌倒风险显著增加有关。据我们所知，这是第一个在普通养老院人群中进行的研究，其中规定了每日跌倒与每日精神药物处方和精神药物组之间的关系。(C) 2016年由Elsevier Inc.代表AMDA（后急性和长期护理医学协会）出版。
Background: Falling is a common and serious problem in the elderly. Previous studies suggest that the use of psychotropic drugs increases the risk of falling. However, the contribution of these drugs on fall risk has not been quantified on a daily basis among the general population of nursing homes until now.Objective: To assess the association between fall incidence and the prescription of psychotropic drugs and different categories of psychotropic drugs (antipsychotics, antidepressants, and benzodiazepines) among a general nursing home population.Design: Retrospective observational study, data collection per person-day.Setting: 9 nursing homes in Eindhoven, the Netherlands.Participants: 2368 nursing home residents, resulting in 538,575 person-days.Main outcome measure: Association between the prescription of psychotropic drugs and falls.Results: A total of 2368 nursing home residents were included, which resulted in a data set of 538,575 person-days. Prescription of at least 1 psychotropic drug per day occurred during a total of 318,128 person-days (59.1%). Scheduled prescriptions with or without an as-needed prescription were involved in a total of 270,781 person-days (50.3%). The prescription of psychotropic drugs on a scheduled basis was found to be associated with almost a 3-fold increase in fall incidence (OR 2.88; 95% CI 1.52-5.44). An increase in fall incidence was found following the prescription of antipsychotics (OR 1.97; 95% CI 1.51-2.59) and antidepressants (OR 2.26; 95% CI 1.73-2.95). This increased fall risk was found for prescriptions on a scheduled basis as well as for prescriptions on an as-needed basis.Conclusion: The prescription of psychotropic drugs is associated with a strongly increased risk of falling among nursing home residents. To our knowledge, this is the first study among the general nursing home population in which the association between daily falls and daily prescriptions of psychotropic drugs and groups of psychotropic drugs was specified. (C) 2016 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.