Garrard J, Makris L, Dunham T, Heston L L, Cooper S, Ratner E R, Zelterman D, Kane R L
Division of Health Services Research and Policy, School of Public Health, St Paul-Ramsey Medical Center, MN.
JAMA. 1991;265(4):463-7.
Federal regulations for use of neuroleptic drugs in Medicare- and Medicaid-certified nursing homes throughout the United States were implemented October 1, 1990. These regulations constitute the first time that prescription drugs are required, by law, to be justified by indications documented in the medical chart. This study used extant data to estimate ineligible neuroleptic use at the individual and nursing home levels had these regulations been in effect in 1976 through 1985. Subjects, randomly sampled admissions (N = 5752) and residents (N = 3191), were followed up for up to 24 months in 60 nursing homes. One half of neuroleptic use in each cohort could be considered ineligible under the regulations; all but one of the nursing homes had one or more individuals who were treated with the ineligible use of neuroleptics. Improvements in documentation and/or prescription of neuroleptic drugs for nursing home elderly will be needed to ensure compliance with these new regulations.
1990年10月1日，美国实施了关于在医疗保险和医疗补助认证的疗养院使用抗精神病药物的联邦法规。这些法规首次依法要求处方药必须有病历中记录的适应症作为依据。本研究利用现有数据估计，如果这些法规在1976年至1985年期间有效，在个体和疗养院层面不符合规定的抗精神病药物使用情况。在60家疗养院中，对随机抽取的入院患者（N = 5752）和居民（N = 3191）进行了长达24个月的随访。根据法规，每个队列中一半的抗精神病药物使用可被视为不符合规定；除了一家疗养院外，所有疗养院都有一名或多名使用不符合规定的抗精神病药物进行治疗的患者。需要改进疗养院老年人抗精神病药物的记录和/或处方，以确保符合这些新法规。
