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停用精神药物可降低需要治疗的跌倒风险。

Withdrawal of psychotropic drugs decreases the risk of falls requiring treatment.

机构信息

Department of Geriatrics, Satakunta Central Hospital, Sairaalantie 3, FI-28550 Pori, Finland.

出版信息

Arch Gerontol Geriatr. 2012 Jan-Feb;54(1):160-7. doi: 10.1016/j.archger.2011.02.015. Epub 2011 Mar 21.

Abstract

This non-randomized, controlled trial assessed the effects of ceasing fall-risk-increasing drugs (FRIDs) (psychotropics or opiates or potent anticholinergics) on the risk of falls requiring medical treatment as a sub-analysis of a randomized, controlled multifactorial fall prevention. The population in this 12-month study consisted of 528 community-dwelling subjects aged 65 years or older with a history of at least one fall. The subjects were divided retrospectively into three groups according to the use of any FRID, any psychotropic drug, and benzodiazepine or related drug (BZD/BZDRD). The subjects in the intervention group (IG) ceasing the drug use were compared with the subjects in IG and the control group (CG) not ceasing the use of the corresponding type of drugs during the intervention period. Falls were recorded from medical records. For the year after the 12-month intervention the relative risk ratio (with 95% confidence intervals=CI) for controls in CG compared with the withdrawal group in IG was 8.26 (1.07-63.73) among the users of psychotropics and 8.11 (1.03-63.60) among the users of BZDs/BZDRDs. Withdrawal of psychotropics, especially BZDs/BZDRDs may have played an important role by lowering the risk of falls requiring medical treatment during the year after the 12-month multifactorial intervention.

摘要

这项非随机、对照试验评估了停止增加跌倒风险的药物(FRIDs)(精神药物或阿片类药物或强效抗胆碱能药物)对需要医疗治疗的跌倒风险的影响,这是一项随机、对照多因素跌倒预防的亚分析。该 12 个月研究的人群包括 528 名居住在社区的 65 岁或以上、至少有一次跌倒史的受试者。根据使用任何 FRID、任何精神药物以及苯二氮䓬类或相关药物(BZD/BZDRD),这些受试者被回顾性地分为三组。干预组(IG)停止使用药物的受试者与干预期间未停止使用相应类型药物的 IG 和对照组(CG)的受试者进行比较。从病历中记录跌倒情况。在 12 个月干预后的一年中,与 IG 停药组相比,CG 对照组中精神药物使用者的相对风险比(95%置信区间=CI)为 8.26(1.07-63.73),BZD/BZDRD 使用者为 8.11(1.03-63.60)。停止使用精神药物,尤其是 BZD/BZDRD,可能通过降低 12 个月多因素干预后需要医疗治疗的跌倒风险,在这一年中发挥了重要作用。

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