Antidopaminergic-Antiparkinsonian Medication Prescribing Cascade in Persons with Alzheimer's Disease.
Antidopaminergic-Antiparkinsonian Medication Prescribing Cascade in Persons with Alzheimer's Disease.
复制标题
DOI：
10.1111/jgs.17013
复制
发表时间：
2021-05
影响因子：
6.3
通讯作者：
Gurwitz JH
中科院分区：
文献类型：
--
作者：
Singh S;Cocoros NM;Haynes K;Nair VP;Harkins TP;Rochon PA;Platt R;Dashevsky I;Reynolds J;Mazor KM;Bloomstone S;Anzuoni K;Crawford SL;Gurwitz JH
患有阿尔茨海默病（AD）的人可能会因更大的多发病，多种药物以及需要更复杂的护理而增加处方级联的风险。我们的目的是评估阿尔茨海默病患者中抗多巴胺能抗帕金森病药物处方级联的比例。美国的两个大型行政索赔数据库。我们确定了2017年1月1日年龄≥50岁的患者，这些患者在入组日期前365天内或入组日期当天至少有一天被分配了用于治疗阿尔茨海默病的药物，并且在入组日期前365天内有医疗和药房保险。我们排除了最近有住院记录的人。我们确定了进入队列后183天内抗多巴胺能药物（抗精神病药/甲氧氯普胺）的使用事件，并确定了随后8-365天内抗帕金森病药物的使用事件。有121，538名阿尔茨海默病患者符合入选条件。约62%为女性，平均年龄为79.5岁（SD ± 8.6）。平均分发药物数量为9.2（SD ± 4.9）。在4，534例抗精神病药/甲氧氯普胺使用者中，有36例抗帕金森病药使用者（0.8%）。我们确定，被广泛认为是高优先级的抗多巴胺能-抗帕金森病药物处方级联的比例很低。我们的方法可用于评估处方级联在被认为是高风险人群中的比例，并优先考虑系统级干预措施，以提高这些患者的用药安全性。
Persons living with Alzheimer’s disease (AD) may be at increased risk for prescribing cascades due to greater multimorbidity, polypharmacy, and the need for more complex care. Our objective was to assess the proportion of the antidopaminergic-antiparkinsonian medication prescribing cascades among persons living with Alzheimer’s disease. Two large administrative claims databases in the United States. We identified patients aged ≥50 on January 1, 2017, who were dispensed a drug used to treat Alzheimer’s disease for at least one day in the 365 days prior to or on cohort entry date and who had medical and pharmacy coverage in the 365 days prior to the cohort entry date. We excluded individuals with a recent institutional stay. We identified incident antidopaminergic (antipsychotic/metoclopramide) use in the 183 days following cohort entry and identified subsequent incident antiparkinsonian drug use within 8–365 days. There were 121,538 patients with Alzheimer’s disease eligible for inclusion. Approximately 62% were women with a mean age of 79.5 (SD ± 8.6). The mean number of drugs dispensed was 9.2 (SD ± 4.9). There were 36 incident antiparkinsonian users among 4,534 incident antipsychotic/metoclopramide users (0.8%). We determined that the proportion of antidopaminergic-antiparkinsonian medication prescribing cascades, widely considered as high-priority, was low. Our approach can be used to assess the proportion of prescribing cascades in populations considered to be at high risk and to prioritize system-level interventional efforts to improve medication safety in these patients.
登录
查看更多内容
影响因子：
105.7
作者：
Rochon, PA;Gurwitz, JH
通讯作者：
Gurwitz, JH
影响因子：
--
作者：
Rochon, PA;Stukel, TA;Gurwitz, JH
通讯作者：
Gurwitz, JH
影响因子：
3.9
作者：
Huh, Youn;Kim, Do-Hoon;Park, Yong-Gyu
通讯作者：
Park, Yong-Gyu
影响因子：
39.2
作者：
Gill, Sudeep S.;Bronskill, Susan E.;Rochon, Paula A.
通讯作者：
Rochon, Paula A.
影响因子：
2.9
作者：
Kim, Siin;Cheon, Sang-Myung;Suh, Hae Sun
通讯作者：
Suh, Hae Sun