University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD, 21218, USA.
Penn State University, University Park, State College, PA, USA.
J Racial Ethn Health Disparities. 2024 Oct;11(5):2839-2847. doi: 10.1007/s40615-023-01745-9. Epub 2023 Aug 14.
The purpose of this study was to describe differences in treatment of White versus Black older adults, males versus females, and those living at home, assisted living, or nursing home communities with regard to the use of psychotropic, pain, and cardiovascular medications. Baseline data from the first 352 participants in the study, implementation of Function-Focused Care for Acute Care Using the Evidence Integration Triangle, were used. Data included age, gender, race, comorbidities, admission diagnosis, and living location prior to hospitalization, the Saint Louis University Mental Status exam, the modified Charlson Comorbidity Index, the Pain Assessment in Advanced Dementia scale, the Confusion Assessment Method, and medications prescribed. Generalized linear mixed model analyses were done, controlling for race or gender (depending on which comparison analysis was being done), age, cognitive status, hospital, delirium, and comorbidities. Medication use was significantly higher for White older adults, compared to Black older adults, for antidepressants, anxiolytics, non-opioid pain medications, and opioids and lower for antihypertensives. Females received more anxiolytics than their male counterparts. There were differences in medication use by living location with regard to non-opioid pain medication, antipsychotics, statins, and anticoagulants. The findings provide some current information about differences in medication use across groups of individuals and can help guide future research and hypothesis testing for approaches to minimizing these differences in treatment.
本研究旨在描述在使用精神药物、疼痛和心血管药物方面,白人与黑人、男性与女性以及居住在家庭、辅助生活或护理院社区的老年患者之间的治疗差异。该研究的前 352 名参与者的基线数据,即“使用证据整合三角实施以功能为导向的急性护理”的数据被用于分析。数据包括年龄、性别、种族、合并症、入院诊断以及住院前的居住地点、圣路易斯大学精神状态检查、改良 Charlson 合并症指数、晚期痴呆症疼痛量表、意识混乱评估方法以及开处方的药物。进行了广义线性混合模型分析,控制了种族或性别(取决于正在进行的比较分析)、年龄、认知状态、医院、谵妄和合并症。与黑人老年人相比,白人老年人使用抗抑郁药、抗焦虑药、非阿片类止痛药和阿片类药物的频率更高,而使用抗高血压药物的频率更低。女性比男性使用更多的抗焦虑药。在非阿片类止痛药、抗精神病药、他汀类药物和抗凝剂方面,居住地点的不同与药物使用存在差异。这些发现提供了一些关于不同群体之间药物使用差异的当前信息,并有助于指导未来的研究和假设检验,以寻求最小化这些治疗差异的方法。