不同认知状态的老年患者在国家阿尔茨海默病协调中心(2006-2019 年)的加巴喷丁使用情况。

Gabapentin utilization among older adults with different cognitive statuses enrolled in the National Alzheimer's Coordinating Center (2006-2019).

机构信息

Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA.

Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA.

出版信息

Br J Clin Pharmacol. 2023 Jan;89(1):410-415. doi: 10.1111/bcp.15532. Epub 2022 Sep 23.

Abstract

This study aimed to examine gabapentin utilization trends among older adults with different cognitive statuses and investigate concurrent medication use of potentially inappropriate medications. Data were extracted from the National Alzheimer's Coordinating Center Uniform Data Set (2006-2019). We estimated the yearly prevalence of gabapentin use, both overall and within subgroups defined by cognitive status (normal, mild cognitive impairment and dementia) and demographics (age and sex) for participants aged 65+. Additionally, we assessed the prevalence of concurrent use of gabapentin with opioids, combined opioids and benzodiazepine, antidepressant and antipsychotic. From 35 205 eligible older adults (mean age [SD]: 75.7 [7.0]; male: 43.1%), gabapentin use increased from 2006 to 2019 in both overall and every participant subgroup. About 10%-30% of gabapentin users reported to concurrently use opioids, and the concurrent use of gabapentin, opioid and benzodiazepine was up to 7.5% throughout the study period. The frequency of concurrent use with antipsychotics or antidepressants was higher in participants with dementia than those with normal cognition or those who were mildly cognitively impaired. Given increasing use among older adults, rigorous studies are needed to examine the safety of gabapentin in this population.

摘要

本研究旨在考察认知状态不同的老年患者中加巴喷丁的使用趋势,并调查潜在不适当药物的同时用药情况。数据取自国家阿尔茨海默病协调中心统一数据集(2006-2019 年)。我们估算了 65 岁及以上参与者中加巴喷丁总体及按认知状态(正常、轻度认知障碍和痴呆)和人口统计学特征(年龄和性别)分组的年使用率,此外还评估了加巴喷丁与阿片类药物、阿片类药物与苯二氮䓬类药物、抗抑郁药和抗精神病药同时使用的发生率。在 35205 名符合条件的老年患者中(平均年龄 [标准差]:75.7 [7.0];男性:43.1%),加巴喷丁的使用在总人群和每个参与者亚组中均从 2006 年增加到 2019 年。约 10%-30%的加巴喷丁使用者报告同时使用阿片类药物,在整个研究期间,加巴喷丁、阿片类药物和苯二氮䓬类药物同时使用的比例高达 7.5%。与认知正常或轻度认知障碍的患者相比,痴呆患者同时使用抗精神病药或抗抑郁药的频率更高。鉴于老年患者中使用量不断增加,需要开展严格的研究来评估加巴喷丁在该人群中的安全性。

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