目的:我们分析了西班牙痴呆患者抗精神病药的患病率,他们的年龄分布以及IACE和美金刚治疗对处方的影响。
方法:描述性,2017年BIFAP数据库对65岁以上痴呆患者的回顾性和横断面研究.抗精神病药的处方,收集IACE和美金刚。还收集了抗精神病药,治疗持续时间和从痴呆诊断到处方的时间。
结果:共检索到1,327,792名受试者,89,464(6.73%)患有痴呆症。抗精神病药的处方占31.76%;按频率:喹硫平(58.47%),利培酮(21%)和氟哌啶醇(19.34%)。IACE和美金刚的处方集中在84岁以下的人群中,抗精神病药的处方集中在85岁以上的人群中(P<.001)。抗精神病药物平均维持1174.5天。在26.4%的病例中,他们是单独开处方的,OR0.61(95%CI:0.59-0.62),在与IACE相关的35.85%中,OR为1.26(95%CI:1.22-1.30),美金刚为42.4%,OR1.69(95%CI:1.62-1.78)(P<.000)。从痴呆症的诊断来看,开处方时经过461天(±1576.5);651天(±1574.25)与IACE相关,1224(±1779)与美金刚相关。
结论:三分之一的痴呆患者服用了抗精神病药,大多是非典型的,在85岁以上的人群中更常见,而且时间更长。IACE和美金刚与抗精神病药处方的风险相关,但矛盾的是,发病时间延长。
OBJECTIVE: We have analyzed the prevalence of antipsychotics in patients with dementia in Spain, their age distribution and the influence of treatment with IACEs and memantine on their prescription.
METHODS: Descriptive, retrospective and cross-sectional study of the 2017 BIFAP database in over 65 years of age with dementia. Prescriptions of antipsychotics, IACEs and memantine were collected. For antipsychotics were also collected, the duration of treatment and time from dementia diagnosis to prescription.
RESULTS: A total of 1,327,792 subjects were retrieved, 89,464 (6.73%) with dementia. Antipsychotics were prescribed in 31.76%; by frequency: quetiapine (58.47%), risperidone (21%) and haloperidol (19.34%). Prescriptions of IACEs and memantine were clustered in those younger than 84 years and antipsychotics in those older than 85 (P<.001). Antipsychotics were maintained for a mean of 1174.5 days. In 26.4% of cases they were prescribed alone, OR 0.61 (95% CI: 0.59-0.62), in 35.85% associated with IACEs, OR 1.26 (95% CI: 1.22-1.30) and in 42.4% with memantine, OR 1.69 (95% CI: 1.62-1.78) (P<.000). From the diagnosis of dementia, 461 days (±1576.5) elapsed when isolated drugs were prescribed; 651 days (±1574.25) associated with IACEs and 1224 (±1779) with memantine.
CONCLUSIONS: One third of patients with dementia were prescribed antipsychotics, mostly atypical, more frequently in those older than 85 years and for prolonged periods. IACEs and memantine were associated with the risk of antipsychotic prescription, but paradoxically, with prolonged time to onset.