Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Cote Ste-Catherine Road, Montreal, Quebec, H3T 1E2, Canada.
Arch Gerontol Geriatr. 2012 Jul-Aug;55(1):66-9. doi: 10.1016/j.archger.2011.06.011. Epub 2011 Aug 6.
Inappropriate and widespread prescribing of antipsychotics in LTCF is of concern. This study aimed to explore the association of resident and room characteristics with antipsychotic use in this setting. This is cross-sectional secondary analysis of the baseline data of 280 residents ≥ 65 years old, from a prospective, observational, LTCF multi-site (n=7) cohort study on delirium. Demographic data included age, sex and length of stay. Resident characteristics assessed were presence of dementia, disruptive behavior, delirium and use of restraints. Room characteristics assessed were single room, clock/calendar, and telephone. Separate logistic regression models were used to explore the association of resident and room characteristics with antipsychotic use, adjusting for demographic variables. Mean age was 84.9 ± 7.0 years (± S.D.) with 56% female. The mean prevalence of antipsychotics use was 31.1% (range: 25.6-50.0%). The regression model of resident characteristics revealed a significant association between disruptive behavior (OR=1.18, 95% CI=1.12-1.25) and antipsychotic use. The model of room characteristics revealed a significant association between absence of a clock or calendar (OR=1.93, 95% CI=1.04-3.56) and absence of a telephone (OR=2.79, 95% CI=1.48-5.25). Our results suggest that behavior problems are associated with a higher likelihood of antipsychotic use. Absence of a clock/calendar and of a telephone was related to antipsychotic use. Further research is needed to confirm these findings.
在长期护理机构中,不适当且广泛使用抗精神病药物令人担忧。本研究旨在探讨居民和房间特征与该环境中抗精神病药物使用的关联。这是一项关于谵妄的前瞻性、观察性、长期护理机构多地点(n=7)队列研究的基线数据的横断面二次分析。人口统计学数据包括年龄、性别和入住时间。评估的居民特征包括痴呆、破坏性行为、谵妄和使用约束。评估的房间特征包括单人房、时钟/日历和电话。使用单独的逻辑回归模型,调整人口统计学变量后,探索居民和房间特征与抗精神病药物使用的关联。平均年龄为 84.9 ± 7.0 岁(± S.D.),女性占 56%。抗精神病药物使用的平均患病率为 31.1%(范围:25.6-50.0%)。居民特征回归模型显示,破坏性行为(OR=1.18,95% CI=1.12-1.25)与抗精神病药物使用显著相关。房间特征模型显示,没有时钟或日历(OR=1.93,95% CI=1.04-3.56)和没有电话(OR=2.79,95% CI=1.48-5.25)与抗精神病药物使用显著相关。我们的结果表明,行为问题与抗精神病药物使用的可能性增加相关。没有时钟/日历和电话与抗精神病药物使用有关。需要进一步的研究来证实这些发现。