Azermai Majda, Elseviers Monique, Petrovic Mirko, Van Bortel Luc, Vander Stichele Robert
Heymans Institute of Clinical Pharmacology, Ghent University, Ghent, Belgium.
Hum Psychopharmacol. 2011 Jan;26(1):12-20. doi: 10.1002/hup.1160.
To determine the prevalence of psychotropic drug use in Belgian nursing homes, in relation to residents' and institutional characteristics.
The PHEBE project (Prescribing in Homes for the Elderly in Belgium, 2005) was a cross-sectional study, investigating drug use in 76 nursing homes. Psychotropics were categorised into antidepressants, antipsychotics, benzodiazepines and anti-dementia drugs using the ATC classification.
Residents' mean age (n=1730) was 85 (SD: 8) years and 78% were female. The overall prevalence of psychotropic drug use among nursing home residents was 79%. Benzodiazepines were used by 54% and antipsychotics by 33% of all residents. Residents received a higher number of antipsychotics ( p<0.001) but fewer antidepressants (and other medicines) with increasing severity of dementia. Antidepressants were prescribed in 40% of which 2/3 was indicated for depression and 1/3 for insomnia. Anti-dementia drugs were used by 8%. Institutional characteristics showed no relationship with psychotropic drug use, except for a lower use when medication was dispensed by a hospital pharmacist (p=0.001).
As in other European countries, the prevalence of psychotropic utilisation in Belgian nursing homes is exceedingly high, with excessive duplicate use. Guidelines, education and clinical practice recommendations focusing on initiation, reassessment and withdrawal of psychotropic therapy, are needed.
确定比利时养老院中精神药物的使用 prevalence，及其与居民和机构特征的关系。
PHEBE 项目（2005 年比利时老年人居家用药）是一项横断面研究，调查了 76 家养老院中的药物使用情况。使用 ATC 分类法将精神药物分为抗抑郁药、抗精神病药、苯二氮䓬类药物和抗痴呆药物。
居民的平均年龄（n = 1730）为 85 岁（标准差：8），78% 为女性。养老院居民中精神药物使用的总体 prevalence 为 79%。所有居民中，54% 使用苯二氮䓬类药物，33% 使用抗精神病药。随着痴呆严重程度的增加，居民使用的抗精神病药数量更多（p < 0.001），但抗抑郁药（和其他药物）数量更少。40% 的居民开具了抗抑郁药，其中 2/3 用于治疗抑郁症，1/3 用于治疗失眠。8% 的居民使用了抗痴呆药物。机构特征与精神药物使用无相关性，但由医院药剂师配药时使用率较低（p = 0.001）。
与其他欧洲国家一样，比利时养老院中精神药物的使用率极高，且存在过度重复使用的情况。需要制定侧重于精神药物治疗的起始、重新评估和停药的指南、教育和临床实践建议。
