Chan Wei-Chieh, Wang Wen-Fu, Tung Yu-Chun, Chang Ming-Che, Chan Hong-Ting, Jhang Kai-Ming
Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Psychiatry. 2024 Jan 16;14:1196801. doi: 10.3389/fpsyt.2023.1196801. eCollection 2023.
Optimal use of psychotropic medications for people living with dementia is important. By finding potentially modifiable factors, dementia care teams may find solutions to achieve the appropriate use of psychotropic drugs.
This study aimed to elucidate patient and caregiver factors associated with the use of psychotropic drugs listed in the potentially inappropriate medications (PIMs) in community-dwelling people with dementia.
This cross-sectional study enrolled 808 patients newly diagnosed with dementia, and their caregivers, from a dementia clinic at Changhua Christian Hospital. Patient and caregiver characteristics, care mode, and social resource usage were recorded. Multivariate logistic regression was used to identify factors associated with prescribing psychotropic medications.
Of all the participants, 39.1% used at least one of psychotropic medication categorized as PIM. Patients with frontotemporal dementia, with behavior or psychological symptoms, or cared by sole foreign care workers; caregivers with higher depression scores, employed or non-spouse caregivers carried a higher risk of prescription of psychotropic medications listed in PIMs.
Psychotropic drug prescriptions are associated with patient and caregiver factors. Therefore, implementing appropriate interventions, especially those targeting potentially modifiable factors, is important to reduce psychotropic medication use.
对痴呆症患者优化使用精神药物很重要。通过找出潜在的可改变因素，痴呆症护理团队可能找到实现精神药物合理使用的解决方案。
本研究旨在阐明与社区居住的痴呆症患者使用潜在不适当药物（PIMs）中列出的精神药物相关的患者和照料者因素。
这项横断面研究纳入了来自彰化基督教医院痴呆症诊所的808名新诊断为痴呆症的患者及其照料者。记录了患者和照料者的特征、护理模式和社会资源使用情况。采用多变量逻辑回归来确定与开具精神药物相关的因素。
在所有参与者中，39.1%使用了至少一种归类为PIM的精神药物。患有额颞叶痴呆、有行为或心理症状的患者，或由外籍护理人员单独照料的患者；抑郁评分较高的照料者、受雇照料者或非配偶照料者开具PIMs中列出的精神药物的风险更高。
精神药物处方与患者和照料者因素相关。因此，实施适当的干预措施，尤其是针对潜在可改变因素的干预措施，对于减少精神药物的使用很重要。
