Impact of the Covid-19 pandemic on neuropsychiatric symptoms and antipsychotic prescribing for people with dementia in nursing home settings.
Impact of the Covid-19 pandemic on neuropsychiatric symptoms and antipsychotic prescribing for people with dementia in nursing home settings.
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DOI：
10.1002/gps.5878
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发表时间：
2023-01
影响因子：
4
通讯作者：
Corbett, Anne
中科院分区：
文献类型：
--
作者：
McDermid, Joanne;Ballard, Clive;Khan, Zunera;Aarsland, Dag;Fox, Chris;Fossey, Jane;Clare, Linda;Moniz-Cook, Esme;Soto-Martin, Maria;Sweetnam, Adrienne;Mills, Kathryn;Cummings, Jeffrey;Corbett, Anne
本研究旨在确定Covid - 19大流行对养老院痴呆症患者神经精神症状和抗精神病药物使用的影响。这是对两项大型养老院研究的基线数据的比较分析，一项是在大流行期间进行的（COVID - iWHELD研究），另一项是在大流行之前进行的（WHELD研究）。它涉及69家和149家养老院的数据，分别有1006名和666名参与者。参与者是已确诊痴呆的人（在临床痴呆评定量表上得分为bbbb1）。居民数据包括人口统计数据、抗精神病药物处方和神经精神病症状，使用的是养老院版本的神经精神病量表。收集的养老院数据是养老院的规模和人员配备信息。神经精神症状的总体患病率与大流行前相比没有变化。整个样本的平均抗精神病药物使用率为32.0%，高于大流行前的18% （Fisher精确检验p < 0.0001）。在养老院层面，抗精神病药物使用的低、中、高三分位数的中位数分别为7%、20%和59%，显示出三分位数的不成比例的上升。这些家庭的居民也表现出轻微但显著的躁动。自COVID - 19大流行以来，养老院的抗精神病药物处方显著增加，三分之一的家庭的抗精神病药物处方率中位数几乎为60%。迫切需要确定这些养老院的策略，并引入积极的支持，使抗精神病药物处方率恢复到大流行前的水平。2019冠状病毒病大流行给养老院行业带来了重大挑战，两家疗养院样本的比较表明，神经精神症状总体上没有变化，但抗精神病药物的处方增加了18%。在本研究纳入的149家疗养院中，有三分之一的疗养院不成比例地增加了抗精神病药物的使用，大多数疗养院都经受住了Covid - 19大流行的影响，并没有看到痴呆症患者使用有害抗精神病药物的增加但有些家庭确实需要帮助才能回到正轨
This study aimed to determine the impact of the Covid‐19 pandemic on neuropsychiatric symptoms and antipsychotic use in people with dementia living in nursing homes. This was a comparative analysis of baseline data from two large nursing home studies, one conducted during (COVID‐iWHELD study) and one prior (WHELD study) to the pandemic. It involves data from 69 and 149 nursing homes, and 1006 and 666 participants respectively. Participants were people with established dementia (score >1 on Clinical Dementia Rating Scale). Resident data included demographics, antipsychotic prescriptions and neuropsychiatric symptoms using the Neuropsychiatric Inventory Nursing Home version. Nursing home data collected were nursing home size and staffing information. Overall prevalence of neuropsychiatric symptoms was unchanged from pre‐pandemic prevalence. Mean antipsychotic use across the sample was 32.0%, increased from 18% pre‐pandemic (Fisher's exact test p < 0.0001). At a nursing home level, the medians for the low, medium and high tertiles for antipsychotic use were 7%, 20% and 59% respectively, showing a disproportionate rise in tertile three. Residents in these homes also showed a small but significant increase in agitation. There has been a significant increase in antipsychotic prescribing in nursing homes since the COVID‐19 pandemic, with a disproportionate rise in one third of homes, where median prescription rates for antipsychotics were almost 60%. Strategies are urgently needed to identify these nursing homes and introduce pro‐active support to bring antipsychotic prescription rates back to pre‐pandemic levels. The Covid‐19 pandemic has presented major challenges to the care home sector, raising the risk of worsening neuropsychiatric symptoms and antipsychotic prescribing practice Comparison of two care home samples indicates no overall change in neuropsychiatric symptoms but an 18% increase in antipsychotic prescribing The increase in antipsychotic use occurred disproportionately in one third of the 149 homes included in this study Most nursing homes have weathered the Covid‐19 pandemic and have not seen increases in use of harmful antipsychotic drugs in residents with dementia but some homes do need help to get back on track
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影响因子：
15.8
作者：
Ballard C;Corbett A;Orrell M;Williams G;Moniz-Cook E;Romeo R;Woods B;Garrod L;Testad I;Woodward-Carlton B;Wenborn J;Knapp M;Fossey J
通讯作者：
Fossey J
影响因子：
6.3
作者：
Brown, Rebecca T.;Shultz, Kaitlyn;Karlawish, Jason;Zhou, Yi;Xie, Dawei;Ryskina, Kira L.
通讯作者：
Ryskina, Kira L.
DOI：
10.1097/01.jgp.0000200589.01396.6d
发表时间：
2006-03-01
影响因子：
7.2
作者：
Schneider, LS;Dagerman, K;Insel, PS
通讯作者：
Insel, PS
影响因子：
15.8
作者：
Ballard, Clive;Lana, Marisa Margallo;Juszczak, Edmund
通讯作者：
Juszczak, Edmund
影响因子：
4.2
作者：
Sultana, Janet;Fontana, Andrea;Trifiro, Gianluca
通讯作者：
Trifiro, Gianluca