Voyer Philippe, Cohen David, Lauzon Sylvie, Collin Johanne
Faculty of nursing, Université Laval, Québec, Canada.
BMC Nurs. 2004 Aug 13;3(1):3. doi: 10.1186/1472-6955-3-3.
In the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support. METHOD: Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined. RESULTS: Most reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed. CONCLUSIONS: The large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.
在许多关于社区居住老年人使用精神类处方药的描述性研究中，一些与药物使用相关的社会人口学因素和其他因素得到的支持并不一致。方法：从主要数据库中识别并分析了1990年至2001年间发表的有关老年人样本中至少使用苯二氮䓬类药物或抗抑郁药物数据的实证报告（n = 32），以确定在多变量分析中哪些因素最常与精神类药物使用相关。还对方法学方面进行了检查。结果：大多数报告使用了使用者和非使用者的概率样本，并采用了横断面设计。在5份或更多报告中考虑的变量中，种族、与健康中心的距离、医疗咨询、睡眠问题和健康认知几乎总是与药物使用相关。性别、心理健康和身体健康状况在约三分之二的报告中相关。通常未观察到与年龄、婚姻状况、药物覆盖范围、社会经济地位和社会支持的关联。结论：用于衡量药物使用、心理健康状况和社会支持的方法种类繁多可能影响了观察到的关系的程度。采用纵向设计并区分短期和长期使用，仅关注药物使用者样本，更统一地定义药物使用和药物类别，并使用幸福感指标而非仅痛苦指标，可能会阐明观察到的关联的性质和因果关系方向。很少有研究检验具体假设。大多数研究关注受访者的个体特征，而忽视了医疗保健专业人员对老年人精神类药物使用现象的潜在影响。
