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全科医疗中痴呆患者的神经精神症状及精神药物使用情况

Neuropsychiatric symptoms and psychotropic drug use in patients with dementia in general practices.

作者信息

Borsje Petra, Lucassen Peter L B J, Wetzels Roland B, Pot Anne Margriet, Koopmans Raymond T C M

机构信息

Department of Primary and Community Care, Alzheimer Centre, Radboud university medical center, Nijmegen, The Netherlands.

Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands.

出版信息

Fam Pract. 2018 Jan 16;35(1):22-28. doi: 10.1093/fampra/cmx061.

Abstract

BACKGROUND

Neuropsychiatric symptoms (NPS) frequently occur in community-dwelling patients with dementia and they are also frequently prescribed psychotropic drugs. The prescription of psychotropic drugs has been found to be associated with the level of NPS. Data on NPS in patients with dementia in general practices are scarce.

OBJECTIVES

The aim of this study was to assess the prevalence rates of NPS and psychotropic drug use (PDU) in patients with dementia in general practices.

METHODS

We analyzed data from the baseline measurement of a prospective cohort study in a sample of (Dutch) patients in general practices. Prevalence rates of NPS and subsyndromes assessed with the Neuropsychiatric Inventory (NPI) and of PDU were calculated. Prevalence rates of individual NPS are presented both as clinically relevant symptoms (NPI symptom score ≥ 4) and as prevalence rates of symptoms with symptom score > 0.

RESULTS

Of the 117 patients, more than 90% had at least one symptom and more than 65% had at least one clinically relevant symptom. The most common NPS were agitation/aggression, dysphoria/depression and irritability/lability. The most common clinically relevant NPS were aberrant motor behaviour, agitation/aggression and apathy/indifference. Only 28.7% of the patients used at least one, 7.0% used at least two different and 1.7% used at least three different types of psychotropic drugs (excluding anti-dementia medication).

CONCLUSIONS

NPS are highly prevalent in patients with dementia in general practices, but PDU is rather low. The most common clinically relevant NPS were aberrant motor behaviour, agitation/aggression and apathy/indifference.

摘要

背景

神经精神症状(NPS)在社区痴呆患者中经常出现,并且他们也经常被开具精神药物。已发现精神药物的处方与NPS水平相关。全科医疗中痴呆患者的NPS数据稀缺。

目的

本研究的目的是评估全科医疗中痴呆患者的NPS患病率和精神药物使用(PDU)情况。

方法

我们分析了一项前瞻性队列研究基线测量的数据,该研究样本为全科医疗中的(荷兰)患者。计算了使用神经精神科问卷(NPI)评估的NPS及其亚综合征的患病率以及PDU的患病率。个体NPS的患病率既以临床相关症状(NPI症状评分≥4)呈现,也以症状评分>0的症状患病率呈现。

结果

在117名患者中,超过90%至少有1种症状,超过65%至少有1种临床相关症状。最常见的NPS是激越/攻击行为、烦躁/抑郁和易怒/情绪不稳定。最常见的临床相关NPS是异常运动行为、激越/攻击行为和淡漠/无动于衷。仅28.7%的患者使用了至少1种、7.0%的患者使用了至少2种不同类型且1.7%的患者使用了至少3种不同类型的精神药物(不包括抗痴呆药物)。

结论

全科医疗中痴呆患者的NPS非常普遍,但PDU相当低。最常见的临床相关NPS是异常运动行为、激越/攻击行为和淡漠/无动于衷。

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