Cooper James W, Freeman Megan H, Cook Christopher L, Burfield Allison H
College of Pharmacy, University of Georgia , Athens, GA ( USA ).
Pharmacy Practice Residency, Northside hospital, Atlanta, GA ( USA ).
Pharm Pract (Granada). 2007 Jul;5(3):140-4. doi: 10.4321/s1886-36552007000300008.
The purpose of this study was to determine if there were any differences in hospitalization rates due to total psychoactive drug "load" between those using and not or formerly using psychotropic and psychoactive medications in a skilled nursing facility; to determine if the diagnosis of dementia and the change in use and load of psychotropic and psychoactive drugs influenced hospitalization rates.
An observational retrospective cohort study was conducted of patient chart, facility disposition changes and consultant pharmacist reports data from a skilled nursing facility of more than 100 beds. Some177 patients resident for 30 or more days over a 19 month period of 2978 patient- months data were tabulated. A monthly repeated- measures assessment method that incorporated all conditions, diseases and medication changes was done on each resident to determine patient demographics, medication usage, and hospitalizations.
The rates of hospitalization ranged from 0.04 to 0.07 per patient/month for any psychoactive usage in those with and without dementia as a diagnosis. The rate of hospitalization during the study period for those with no current psychotropic nor regular psychoactive usage was 0.02 and 0.03/pt./month for those respectively with and without the diagnosis of dementia, yet 86% of this sample had used psychotropics or other psychoactive drugs before the period of observation.
Preliminary evidence is offered that suggests psychotropics and psychoactive drugs and the total "load" of these drugs may be associated with an increase in the rate and risk of all hospitalizations within a single skilled nursing facility.
本研究的目的是确定在一家专业护理机构中，使用和未使用或曾使用精神药物和精神活性药物的人群因精神活性药物“负荷”总量导致的住院率是否存在差异；确定痴呆症诊断以及精神药物和精神活性药物的使用及负荷变化是否会影响住院率。
对一家拥有100多张床位的专业护理机构的患者病历、机构处置变化和顾问药剂师报告数据进行了一项观察性回顾性队列研究。在2978个患者月的数据中，列出了177名在19个月期间住院30天或更长时间的患者。对每位居民采用每月重复测量评估方法，纳入所有病症、疾病和药物变化情况，以确定患者人口统计学特征、药物使用情况和住院情况。
诊断为痴呆症和未诊断为痴呆症的患者中，任何精神活性药物使用情况下的住院率为每位患者/月0.04至0.07。在研究期间，目前未使用精神药物或常规精神活性药物的患者中，诊断为痴呆症和未诊断为痴呆症的患者住院率分别为0.02和0.03/患者/月，但该样本中86%的人在观察期之前曾使用过精神药物或其他精神活性药物。
初步证据表明，精神药物和精神活性药物以及这些药物的总“负荷”可能与单一专业护理机构内所有住院率和风险的增加有关。
