Downs Tara, Wilson Jaime, Brewer Sherry, Miller Karla, Swee Melissa, Taylor Virginia, Betts-Jimenez Issis, Imel Janna, Graham Cassie
Pharmacy, Lexington Veterans Affairs Health Care System, Lexington, USA.
Veterans Health Administration Rural Scholars Fellowship, Office of Rural Health Veteran Rural Health Resource Center, Iowa City, USA.
Cureus. 2024 Nov 7;16(11):e73232. doi: 10.7759/cureus.73232. eCollection 2024 Nov.
Background This project investigates a music intervention to deprescribe antipsychotics in rural Veterans with dementia. Methods The Veterans Health Administration Home-Based Primary Care Program is care provided in the home by an interdisciplinary team with the goals of decreasing hospitalizations and falls, providing education to patients and caregivers, and improving quality of life. Eighteen Home Based Primary Care Veterans with dementia and active antipsychotic prescriptions were identified with the goal to deprescribe antipsychotics in 50% of them using a music intervention. Individualized playlists and assessments for Veteran quality of life and caregiver burden were evaluated. Phone visits tracked music utilization and captured the voice of the customer. Results Antipsychotic dose reduction occurred in five of eight Veterans, totaling eight dose reductions and one discontinuation. Veteran quality of life improved; however, caregiver burden increased initially. The caregiver burden did improve when an outlier was removed. The voice of the customer favored music intervention. Conclusions A personalized music intervention is a feasible approach for reducing antipsychotic use in rural Veterans, improving quality of life, and potentially reducing caregiver burden.
背景 本项目研究一种音乐干预措施，以减少农村地区患有痴呆症退伍军人的抗精神病药物使用。方法 退伍军人健康管理局的家庭初级保健项目是由一个跨学科团队在患者家中提供的护理服务，其目标是减少住院率和跌倒次数，为患者及其护理人员提供教育，并提高生活质量。确定了18名患有痴呆症且正在服用抗精神病药物的家庭初级保健退伍军人，目标是通过音乐干预措施，使其中50%的人停用抗精神病药物。对个性化播放列表以及退伍军人生活质量和护理人员负担的评估进行了评估。通过电话随访跟踪音乐使用情况并收集用户反馈。结果 八名退伍军人中有五人减少了抗精神病药物剂量，总共减少了八次剂量并停用了一次。退伍军人的生活质量得到改善；然而，护理人员的负担最初有所增加。去除一个异常值后，护理人员的负担确实有所改善。用户反馈支持音乐干预措施。结论 个性化音乐干预是减少农村退伍军人抗精神病药物使用、改善生活质量并可能减轻护理人员负担的一种可行方法。
