Melatonin Prescribing in Assisted Living.
Melatonin Prescribing in Assisted Living.
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DOI：
10.1016/j.jamda.2021.10.005
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发表时间：
2022-06
影响因子：
7.6
通讯作者：
Sloane, Philip D.
中科院分区：
文献类型：
--
作者：
Peketi, Punita;Zimmerman, Sheryl;Palmertree, Stephanie;Wretman, Christopher J.;Preisser, John S.;Sloane, Philip D.
老龄化与睡眠问题有关，这在辅助生活(AL)居民中很常见。超过40%的居民有失眠，近70%的居民有某种程度的睡眠障碍。褪黑素治疗睡眠障碍在老年人中已经很常见，但它在AL中的用途尚不清楚，这一点令人担忧，因为褪黑素可能会有副作用，并干扰其他药物。这项研究的目的是确定急性白血病患者服用褪黑素的患病率和相关性，以告知是否可以指示护理的变化。横断面图摘要和访谈。数据是在美国7个州5777名居民中随机选择的250个AL社区收集的，加权后估计有4043个社区和152,719名居民。研究人员提取了居民的图表，并采访了AL管理人员和卫生保健主管，以获得与病例组合、人员配置和对精神活性药物的态度有关的信息。加权分析主要研究了褪黑激素处方与社区和居民水平特征的关联。82%的社区使用褪黑素，更常见的是在现场有注册护士或执业护士的社区(+7%，P=.027)，以及其卫生保健主管更倾向于非药物实践的社区(+18%，P=.010)。平均而言，9%的居民服用褪黑素，其中更常见的是患有痴呆症(+24%，P=.004)、精神障碍，特别是焦虑症(+43%，P=.007)、有行为表现和服用其他精神药物的人。对照试验很常见，尤其是抗抑郁药(OR2.64，95%可信区间1.99，3.48；P<；.001)。这项研究是第一次检查急性白血病患者服用褪黑素的情况，并发现这种情况很常见。如果它作为催眠药的更合适的替代品，这种使用可能是合适的。使用情况因组织特征不同而不同，这表明实践可能是可以修改的。研究褪黑素的益处和副作用，总体上以及与其他药物的关系，是为了促进对AL患者的更好护理。
Aging is associated with sleep problems, which are common among assisted living (AL) residents. More than 40% of residents have insomnia, and almost 70% have a sleep disturbance of some kind. Melatonin to treat sleep disorders has become common among older adults, but its use in AL is unknown, which is concerning because melatonin may have side effects and interfere with other medications. The purpose of this study was to determine the prevalence and correlates of melatonin prescribing in AL, to inform whether changes in care may be indicated. Cross-sectional chart abstracts and interviews. Data were collected in 250 randomly selected AL communities among 5777 residents across 7 states in the United States and weighted to an estimated 4043 communities and 152,719 residents. Charts of residents were abstracted, and AL administrators and health care supervisors were interviewed to obtain information related to case-mix, staffing, and attitudes regarding psychoactive medications. Weighted analyses primarily examined the association of melatonin prescribing with community- and resident-level characteristics. Melatonin was prescribed in 82% of communities, more commonly in those that had a registered nurse or licensed practical nurse on site (+7%, P = .027), and whose health care supervisor was more favorable toward nonpharmacologic practices (+18%, P = .010). On average, 9% of residents were prescribed melatonin, with prescriptions being more common among those diagnosed with dementia (+24%, P = .004); a psychiatric disorder, especially an anxiety disorder (+43%, P = .007); having behavioral expressions; and taking other psychotropics. Coprescribing was common, especially with antidepressants (OR 2.64, 95% CI 1.99, 3.48; P < .001). This study is the first to examine melatonin prescribing in AL, and finds it to be common. Such use may be appropriate if it is as a more suitable replacement for hypnotics. The fact that use varies by organizational characteristics suggests practices may be modifiable. Research examining benefits and side effects of melatonin, overall and in relation to other medications, is indicated to promote better care for AL residents.
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影响因子：
--
作者：
Pierce, Mackenzie;Linnebur, Sunny A.;Fixen, Danielle R.
通讯作者：
Fixen, Danielle R.
影响因子：
4
作者：
Rao, V;Spiro, JR;Lyketsos, CG
通讯作者：
Lyketsos, CG
影响因子：
4.1
作者：
WALDHAUSER, F;LIEBERMAN, HR;CROWLEY, WF
通讯作者：
CROWLEY, WF
影响因子：
1.7
作者：
Doghramji, Karl;Jangro, William C.
通讯作者：
Jangro, William C.
DOI：
10.1111/j.1532-5415.2004.52452.x
发表时间：
2004-10-01
影响因子：
6.3
作者：
Rosenblatt, A;Samus, QM;Lyketsos, CG
通讯作者：
Lyketsos, CG