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首页> 外文期刊>The British journal of psychiatry : >Antipsychotics in dementia: Prevalence and quality of antipsychotic drug prescribing in UK mental health services
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Antipsychotics in dementia: Prevalence and quality of antipsychotic drug prescribing in UK mental health services

机译：痴呆症中的抗精神病药：英国精神卫生服务中抗精神病药处方的普遍性和质量

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Background: Up to a quarter of people in the UK with a diagnosis of dementia are prescribed an antipsychotic in any year. The potential risks of such treatment are becoming clearer, but the benefits remain uncertain. Concern about the frequency and quality of such prescribing was expressed in the National Dementia Strategy for England in 2009. Aims: To provide an estimate of the prevalence of antipsychotic use for dementia in secondary mental health services in the UK and to collect data relevant to quality improvement initiatives for such prescribing practice. Method: In the context of a UK quality improvement programme, relevant clinical audit data were collected for patients with dementia under the care of specialist older people's mental health services. Results: Fifty-four mental health National Health Service (NHS) trusts submitted data on 10 199 patients. Of those patients without comorbid psychotic illness, 1620 (16%) were prescribed an antipsychotic; the common clinical indications for such medication were agitation, psychotic symptoms, aggression and distress. Multivariable regression found younger age, care home or in-patient setting, vascular or Parkinson's disease dementia and greater severity of dementia to be all significantly associated with being prescribed antipsychotic medication. Of the 1001 (62%) patients prescribed treatment for more than 6 months, only three-quarters had a documented review of therapeutic response in the previous 6 months. Conclusions: The data reveal areas of relatively good current practice, including consideration of alternatives to antipsychotic medication and clear documentation of target symptoms. They also suggest areas for improvement, such as the frequency and quality of review of long-term medication. Strategies to reduce antipsychotic use should take account of the demographic and clinical variables predicting increased likelihood of antipsychotic prescription.
机译：背景：在英国，每年有多达四分之一的被诊断为痴呆症的人被处方抗精神病药。这种治疗的潜在风险正在变得越来越明显，但是收益仍然不确定。 2009年，英国《国家痴呆症策略》对这种处方的频率和质量表示关注。目的：提供抗精神病药在英国二级精神卫生服务中用于痴呆的患病率的估算，并收集与质量有关的数据此类处方实践的改进措施。方法：在英国质量改善计划的背景下，在专业的老年人心理健康服务的护理下，收集了有关痴呆患者的相关临床审计数据。结果：54个精神健康国家卫生服务（NHS）信托提交了10 199例患者的数据。在那些没有合并精神病的患者中，有1620人（16％）被开了抗精神病药。这种药物的常见临床指征是躁动，精神病症状，攻击性和困扰。多变量回归发现年龄较小，家庭护理或住院环境，血管性或帕金森氏病痴呆症和痴呆症严重程度均与处方抗精神病药物显着相关。在接受处方治疗超过6个月的1001名患者（62％）中，只有四分之三的患者在过去6个月中对治疗反应进行了文献复习。结论：数据揭示了目前相对较好的实践领域，包括考虑使用抗精神病药物的替代方法以及明确记录目标症状。他们还提出了需要改进的领域，例如长期药物复查的频率和质量。减少抗精神病药物使用的策略应考虑预测抗精神病药物处方可能性增加的人口统计学和临床​​变量。

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