Kobayashi Masaki, Une Saki, Hara Hisao, Honda Miwako
Internal Medicine, Unity Hospital, Rochester Regional Health, Rochester, USA.
General Internal Medicine, Division of Geriatric Research, National Hospital Organization Tokyo Medical Center, Tokyo, JPN.
Cureus. 2024 Jun 28;16(6):e63413. doi: 10.7759/cureus.63413. eCollection 2024 Jun.
Aim This study aimed to assess the trends in psychotropic drug prescriptions among elderly residents with dementia following the continuous implementation of multimodal comprehensive care communication skills training for staff in a long-term care facility. Methods This retrospective single-center cross-sectional study utilized the database of an urban public hospital that included a long-term care facility. The data were collected from 2016 to 2020. All 130 staff members at the hospital (52 nurses, 48 professional caregivers, seven rehabilitation staff members, three physicians, and three pharmacists) initiated multimodal comprehensive care communication skills basic training from October 2014 to December 2015, which was followed by continuous monthly training until the end of 2020. Antipsychotic prescription rates for residents aged over 65 years with dementia were measured throughout the study period. Results A total of 506 eligible residents were identified, the median age was 86.0 years (IQR: 81.0-90.0), and 283 (55.9%) residents were females. The prescription rates for psychotropic drugs among residents with dementia decreased significantly (43.5% in 2016, 27.0% in 2020; p=0.01). Notably, the percentage of patients prescribed anxiolytics decreased significantly (from 4.7% to 0.0%), while the percentage of patients receiving antipsychotic drugs, hypnotics, antidepressants, or antiepileptic drugs remained unchanged over time. The prescription rates for antidementia drugs significantly decreased from 15.3% to 4.0%. Conclusion The prescription rates of psychotropic drugs were significantly reduced following multimodal comprehensive care communication skills training for staff at a long-term care facility. The improvement in communication skills among staff at long-term care facilities has a tangible impact on reducing drug use among elderly residents with dementia.
目的 本研究旨在评估在长期护理机构中对工作人员持续开展多模式综合护理沟通技能培训后，老年痴呆症居民精神药物处方的趋势。方法 这项回顾性单中心横断面研究利用了一家城市公立医院（其中包括一个长期护理机构）的数据库。数据收集时间为2016年至2020年。该医院的所有130名工作人员（52名护士、48名专业护理人员、7名康复工作人员、3名医生和3名药剂师）于2014年10月至2015年12月开始接受多模式综合护理沟通技能基础培训，随后每月持续培训直至2020年底。在整个研究期间测量65岁以上痴呆症居民的抗精神病药物处方率。结果 共确定了506名符合条件的居民，中位年龄为86.0岁（四分位间距：81.0 - 90.0），283名（55.9%）居民为女性。痴呆症居民中精神药物的处方率显著下降（2016年为43.5%，2020年为27.0%；p = 0.01）。值得注意的是，开具抗焦虑药的患者百分比显著下降（从4.7%降至0.0%），而接受抗精神病药物、催眠药、抗抑郁药或抗癫痫药的患者百分比随时间保持不变。抗痴呆药物的处方率从15.3%显著降至4.0%。结论 在长期护理机构对工作人员进行多模式综合护理沟通技能培训后，精神药物的处方率显著降低。长期护理机构工作人员沟通技能的提高对减少老年痴呆症居民的药物使用有切实影响。
