Resnick Barbara, Kolanowski Ann, Van Haitsma Kimberly, Galik Elizabeth, Boltz Marie, Ellis Jeanette, Behrens Liza, Eshraghi Karen, Zhu Shijun
University of Maryland School of Nursing, Baltimore, USA.
Pennsylvania State University College of Nursing, University Park, USA.
Clin Nurs Res. 2021 Jan;30(1):59-69. doi: 10.1177/1054773819838678. Epub 2019 Apr 3.
This study described current use and predictors of psychotropics among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in an ongoing trial. Predictive measures included age, gender, race, depressive symptoms, agitation, resistiveness to care, depression, cognition, pain, comorbidities, facility factors, and state. Overall 63% ( = 211) received at least one psychotropic medication, 16% ( = 52) an anti-seizure medication, 23% ( = 77) an anxiolytic, 30% ( = 99) an antidepressant, 2% ( = 8) a sedative hypnotic, 28% ( = 93) an antipsychotic medication, and 9% ( = 29) an opioid. Testing of models explained 9% to 15% of psychotropic medication use. There were high rates of psychotropic medication use and a limited association between demographic factors, behavioral symptoms, and psychotropic medication use. Continued research is needed to explore the impact of deprescribing, person-centered behavioral interventions, and beliefs of providers on psychotropic medication use.
本研究描述了中重度认知障碍患者使用精神药物的现状及预测因素。这是一项二次数据分析，使用了一项正在进行的试验中前341名患者的基线数据。预测指标包括年龄、性别、种族、抑郁症状、激越、护理抗拒、抑郁、认知、疼痛、合并症、机构因素和所在州。总体而言，63%（n = 211）的患者至少服用了一种精神药物，16%（n = 52）服用了抗癫痫药物，23%（n = 77）服用了抗焦虑药物，30%（n = 99）服用了抗抑郁药物，2%（n = 8）服用了镇静催眠药，28%（n = 93）服用了抗精神病药物，9%（n = 29）服用了阿片类药物。模型检验解释了精神药物使用情况的9%至15%。精神药物使用率较高，人口统计学因素、行为症状与精神药物使用之间的关联有限。需要持续开展研究，以探讨减药、以患者为中心的行为干预以及医护人员的观念对精神药物使用的影响。
