Philippe Anne-Sophie, Braunstein David, Clot-Faybesse Priscilla, Teissier Sylvie, Roch Bénédicte, Micallef Joëlle, Bonin-Guillaume Sylvie
Département universitaire de médecine générale, Aix-Marseille-Université, Marseille, France, Service de médecine interne et gériatrie, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, AP-HM, Marseille, France.
Service de pharmacologie clinique et pharmacovigilance, Assistance Publique des Hôpitaux de Marseille, AP-HM, France, Institut des neurosciences Timone, CNRS-UMR 7289, Aix-Marseille-Université, Marseille, France.
Geriatr Psychol Neuropsychiatr Vieil. 2018 Dec 1;16(4):383-390. doi: 10.1684/pnv.2018.0754.
Despite the context of several national warnings, antipsychotics drugs are commonly used to treat behavioural and psychological symptoms in dementia (BPSD).
To observe a decrease of antipsychotic drug prescription, in old NH (nursing homes) residents with dementia, after an awareness of their general practitioner.
Observational, prospective, multicenter study. The study population corresponds to NH residents with dementia, and antipsychotic drug consumption, in nursing homes volunteered to participate. Awareness-raising is carried out through information documents. The evaluation criteria is the proportion of residents under antipsychotics after sensitization.
out of the 30 nursing homes included, 26.7% of the patients were prescribed at least one antipsychotic and 15% were both demented and under antipsychotics. A total of 317 residents with dementia and antipsychotics were included 15% of the total NH population. Psychotropic drug co-prescriptions was very frequent 43.2% also used benzodiazepines, 37.2% anxiolytics and 33.1% antidepressants. Agitation, aggressiveness, opposition to care and wandering were the most commonly BPSD encountered. After a first sensitization, we obtained a 15.5% decrease of antipsychotic prescriptions.
A personalized sensitization towards GP allowed a reduction of antipsychotic drugs prescription in NH residents with dementia and BPSD.
尽管有多项国家警告，但抗精神病药物仍常用于治疗痴呆症的行为和心理症状（BPSD）。
观察在全科医生提高认识后，老年养老院痴呆症患者抗精神病药物处方量的减少情况。
观察性、前瞻性、多中心研究。研究人群为自愿参与的养老院中患有痴呆症且正在使用抗精神病药物的居民。通过信息文件进行宣传。评估标准是宣传后使用抗精神病药物的居民比例。
在纳入的30家养老院中，26.7%的患者至少开具了一种抗精神病药物，15%的患者既患有痴呆症又使用抗精神病药物。共有317名患有痴呆症且使用抗精神病药物的居民被纳入，占养老院总人数的15%。精神药物联合处方非常常见，43.2%的患者还使用苯二氮䓬类药物，37.2%使用抗焦虑药，33.1%使用抗抑郁药。激越、攻击性、抗拒护理和徘徊是最常见的BPSD症状。在首次宣传后，我们使抗精神病药物处方量减少了15.5%。
对全科医生进行个性化宣传可减少养老院中患有痴呆症和BPSD的居民的抗精神病药物处方量。
