Department of Geriatrics, Satakunta Hospital District, Pori, Sairaalantie 3 FI 28500, Finland.
Age Ageing. 2010 May;39(3):313-9. doi: 10.1093/ageing/afp255. Epub 2010 Jan 20.
evidence about possibilities to help older persons to withdraw the long-term use of benzodiazepines (BZD) is scarce. Effective and practicable methods are needed.
the study aimed to assess the persistence of one-time counselling by a geriatrician to reduce psychotropic drugs, especially BZD and related drugs (RD).
a prospective randomised controlled trial with a 12-month follow-up was conducted.
five hundred ninety-one community-dwelling people aged 65 or older participated in the study.
instructions to withdraw, reduce or change psychotropic drugs were given to the intervention group. A 1-h lecture about these drugs and their adverse effects was given later on. No changes in the drug therapy were suggested for the controls.
the number of regular users of BZD and RD decreased by 35% (12/34) (odds ratios (OR) = 0.61, 95% confidence interval (95% CI) 0.44-0.86) in the intervention group while it increased by 4% (2/46) (OR = 1.05, 95% CI 0.81-1.36) in the controls (P = 0.012). No significant changes in the users of other types of psychotropics were found.
one-time counselling of psychotropics and other fall-risk-increasing drugs by a geriatrician followed with a 1-h lecture about adverse effects of these drugs had positive effects in decreasing the number of regular users of BZD and RD, and these effects persisted for the total 12-month intervention period.
关于帮助老年人停止长期使用苯二氮䓬类药物(BZD)的可能性的证据很少。需要有效的和可行的方法。
本研究旨在评估老年医生一次性咨询以减少精神药物,特别是 BZD 和相关药物(RD)的持续效果。
进行了一项为期 12 个月随访的前瞻性随机对照试验。
591 名居住在社区的 65 岁或以上的人参加了这项研究。
向干预组提供了停止、减少或改变精神药物的指示。后来,还为他们提供了关于这些药物及其不良反应的 1 小时讲座。对照组的药物治疗没有变化。
在干预组中,BZD 和 RD 的常规使用者数量减少了 35%(12/34)(比值比(OR)=0.61,95%置信区间(95%CI)0.44-0.86),而对照组则增加了 4%(2/46)(OR=1.05,95%CI 0.81-1.36)(P=0.012)。其他类型精神药物的使用者没有发现明显的变化。
老年医生一次性咨询精神药物和其他增加跌倒风险的药物,并随后进行这些药物不良反应的 1 小时讲座,对减少 BZD 和 RD 的常规使用者数量有积极影响,并且这些效果持续了整个 12 个月的干预期。