Antidementia Medication Use in Nursing Home Residents
Journal of Geriatric Psychiatry and Neurology,
Год журнала:
2023,
Номер
37(3), С. 194 - 205
Опубликована: Сен. 16, 2023
Background
Antidementia
medication
can
provide
symptomatic
improvements
in
patients
with
Alzheimer’s
disease,
but
there
is
a
lack
of
consensus
guidance
on
when
to
start
and
stop
treatment
the
nursing
home
setting.
Methods
We
describe
utilization
patterns
cholinesterase
inhibitors
(ChEI)
memantine
for
3,50,197
newly
admitted
NH
residents
dementia
between
2011
2018.
Results
Overall,
pre-admission
use
antidementia
medications
declined
from
2018
(ChEIs:
44.5%
36.9%;
memantine:
27.4%
23.2%).
Older
age,
feeding
tube,
greater
functional
dependency
were
associated
lower
odds
ChEI
initiation.
Coronary
artery
parenteral
nutrition,
severe
aggressive
behaviors,
cognitive
impairment,
high
discontinuation
ChEIs.
Comparison
clinical
factors
related
anti-dementia
drug
changes
pre
post
admission
revealed
change
toward
likelihood
initiation
among
more
those
indicators
complex
illness
as
well
higher
having
2
or
hospital
stays.
Conclusions
These
prescribing
trends
highlight
need
additional
research
effects
initiating
discontinuing
clear
clinicians
making
decisions
individual
residents.
Язык: Английский
Health service use before and after dementia diagnosis: a retrospective matched case–control study
BMJ Open,
Год журнала:
2022,
Номер
12(11), С. e067363 - e067363
Опубликована: Ноя. 1, 2022
This
study
investigated
patterns
in
health
service
usage
among
older
adults
with
dementia
and
matched
controls
over
a
10-year
span
from
5
years
before
until
after
diagnosis.
Population-based
retrospective
case-control
study.
Administrative
data
of
individuals
Saskatchewan,
Canada
1
April
2008
to
31
March
2019.
The
included
2024
aged
65
living
the
community
at
time
diagnosis
2013
2014,
1:1
without
on
age
group,
sex,
rural
versus
urban
residence,
geographical
region
comorbidity.
For
each
5-year
period
diagnosis,
we
examined
services
year
including
family
physician
(FP)
visits,
specialist
hospital
admissions,
all-type
prescription
drug
dispensations
short-term
care
admissions.
We
used
negative
binomial
regression
estimate
effect
yearly
average
utilisation
adjusting
for
region,
prior
use
Adjusted
findings
demonstrated
that
all
except
hospitalisation
was
lower
persons
than
(all
p<0.001).
After
this
point,
differences
higher
compared
were
greatest
In
visits
59.7%
(p<0.001)
hospitalisations
90.5%
(p<0.001).
FP
70.0%
prescriptions
29.1%
Findings
suggest
offer
multiple
opportunities
implement
quality
supports.
FPs
are
integral
require
effective
resources
properly
serve
population.
Язык: Английский