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长期护理帕金森病精神病患者的抗精神病药物治疗模式。

Treatment Patterns With Antipsychotics in Long-Term Care Patients With Parkinson's Disease Psychosis.

机构信息

Acadia Pharmaceuticals Inc., San Diego, CA, USA.

Confidio, Towson, MD, USA.

出版信息

J Appl Gerontol. 2022 Jan;41(1):198-206. doi: 10.1177/0733464820987032. Epub 2021 Jan 27.

Abstract

This study assessed treatment change patterns in Parkinson's disease psychosis (PDP) residents receiving antipsychotic (AP) therapies in U.S. long-term care (LTC) facilities. Residents with PDP in LTC between 01/01/13 and 06/30/16 were identified with ≥1 claim of psychosis, hallucinations, or delusions after PD diagnosis. Treatment patterns were evaluated during the 12 months post index. We identified 864 PDP residents: 408 (47.2%) on AP therapy and 456 (52.8%) on no AP therapy. A total of 335 residents (82.1%) continued, 13 (3.2%) discontinued, 11 (2.7%) switched, and 49 (12.0%) augmented (used ≥2 APs) their index AP therapy. Based on the multivariate regression analysis, younger age, male gender, anemia, anxiolytic use or anxiety, sedatives/hypnotic use, bladder disorders including urinary tract infections, coronary conditions, diabetes, hypertension, and dementia were associated with a higher likelihood of treatment change. Understanding the factors associated with treatment change may inform ways to improve management of PDP in the U.S. LTC setting.

摘要

这项研究评估了美国长期护理(LTC)机构中接受抗精神病药物(AP)治疗的帕金森病精神病(PDP)患者的治疗方案变化。在 2013 年 1 月 1 日至 2016 年 6 月 30 日期间,LTC 中有 PDP 的居民在 PD 诊断后至少有 1 次精神病、幻觉或妄想的索赔。在指数后 12 个月内评估了治疗模式。我们确定了 864 名 PDP 患者:408 名(47.2%)接受 AP 治疗,456 名(52.8%)未接受 AP 治疗。共有 335 名患者(82.1%)继续治疗,13 名(3.2%)停药,11 名(2.7%)换药,49 名(12.0%)增加(使用≥2 种 AP)他们的索引 AP 治疗。基于多变量回归分析,年龄较小、男性、贫血、焦虑症使用或焦虑、镇静剂/催眠剂使用、包括尿路感染在内的膀胱疾病、冠状动脉疾病、糖尿病、高血压和痴呆与治疗方案改变的可能性更高相关。了解与治疗方案改变相关的因素可能有助于改善美国 LTC 环境中 PDP 的管理。

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