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Antipsychotic drug use in nursing home residents with and without dementia: keep an eye on the pro re nata medication.
International Clinical Psychopharmacology ( IF 2.6 ) Pub Date : 2017-3-28 , DOI: 10.1097/yic.0000000000000173
Katharina Allers 1 , Michael Dörks , Guido Schmiemann , Falk Hoffmann
Affiliation  

Behavioral and psychological symptoms of dementia often lead to the prescription of antipsychotics, especially in nursing homes, but their use remains controversial. This study aimed to assess antipsychotic drug use in residents with dementia compared with those without dementia. Data were obtained through the cross-sectional 'inappropriate medication in patients with renal insufficiency in nursing homes' (IMREN) study including data from 21 nursing homes. Descriptive statistics were used and factors associated with the prescription of antipsychotics were identified by logistic regression. Overall, 57.5% of the 837 residents had a diagnosis of dementia and 47.0% of residents with dementia and 19.5% of those without dementia received antipsychotics. 35.9% of all antipsychotics in residents with dementia were prescribed as pro re nata (PRN) compared with 23.0% for residents without dementia. Typical antipsychotics were prescribed more commonly than atypical ones. The adjusted logistic regression showed a significant association between the prescription of antipsychotics and dementia (odds ratio: 3.58, 95% confidence interval: 2.45-5.25) as well as severe care dependency (odds ratio: 1.68, 95% confidence interval: 1.10-2.55). Despite safety warnings, antipsychotics are still frequently prescribed to residents with dementia. Almost half received antipsychotics and about a third of the antipsychotics are prescribed as PRN. Further studies should assess the use of PRN antipsychotics and guidelines for PRN prescriptions are clearly needed.

中文翻译:

在患有和不患有痴呆症的疗养院居民中使用抗精神病药物:关注前列腺癌药物。

痴呆症的行为和心理症状通常会导致服用抗精神病药,尤其是在疗养院中,但仍存在争议。本研究旨在评估患有痴呆症的居民与未患有痴呆症的居民相比使用抗精神病药物的情况。通过横断面“疗养院肾功能不全患者用药不当”(IMREN)研究获得的数据,包括来自21个疗养院的数据。使用描述性统计数据,并通过逻辑回归确定与抗精神病药处方相关的因素。总体而言,837例居民中有57.5%被诊断出患有痴呆症,患有痴呆症的居民占47.0%,而没有痴呆症的居民中有19.5%接受了抗精神病药治疗。35岁 患有痴呆症的居民中有9%的抗精神病药物被处方为pro nata(PRN),而没有痴呆症的居民中有23.0%被指定为pro nata。典型的抗精神病药比非典型药物更常见。调整后的逻辑回归显示,抗精神病药和痴呆症的处方(赔率:3.58,95%置信区间:2.45-5.25)与严重护理依赖关系(赔率:1.68,95%置信区间:1.10-2.55)之间存在显着相关性。 )。尽管有安全警告,痴呆症患者仍经常服用抗精神病药。几乎一半接受抗精神病药,约三分之一的抗精神病药被规定为PRN。进一步的研究应评估PRN抗精神病药的使用,显然需要制定PRN处方指南。典型的抗精神病药比非典型药物更常见。调整后的逻辑回归显示,抗精神病药和痴呆症的处方(赔率:3.58,95%置信区间:2.45-5.25)与严重护理依赖关系(赔率:1.68,95%置信区间:1.10-2.55)之间存在显着相关性。 )。尽管有安全警告,痴呆症患者仍经常服用抗精神病药。几乎一半接受抗精神病药,约三分之一的抗精神病药被规定为PRN。进一步的研究应评估PRN抗精神病药的使用,显然需要制定PRN处方指南。典型的抗精神病药比非典型药物更常见。调整后的逻辑回归显示,抗精神病药和痴呆症的处方(赔率:3.58,95%置信区间:2.45-5.25)与严重护理依赖关系(赔率:1.68,95%置信区间:1.10-2.55)之间存在显着相关性。 )。尽管有安全警告,痴呆症患者仍经常服用抗精神病药。几乎一半接受抗精神病药,约三分之一的抗精神病药被规定为PRN。进一步的研究应评估PRN抗精神病药的使用,显然需要制定PRN处方指南。95%置信区间:2.45-5.25)以及重症监护依赖(赔率:1.68,95%置信区间:1.10-2.55)。尽管有安全警告,痴呆症患者仍经常服用抗精神病药。几乎一半接受抗精神病药,约三分之一的抗精神病药被规定为PRN。进一步的研究应评估PRN抗精神病药的使用,显然需要制定PRN处方指南。95%置信区间:2.45-5.25)以及重症监护依赖(赔率:1.68,95%置信区间:1.10-2.55)。尽管有安全警告,痴呆症患者仍经常服用抗精神病药。几乎一半接受抗精神病药,约三分之一的抗精神病药被规定为PRN。进一步的研究应评估PRN抗精神病药的使用,显然需要制定PRN处方指南。
更新日期:2020-12-17
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