老年群体中的长效注射抗精神病药物：纵向研究

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry Pub Date : 2024-07-04 DOI:10.1016/j.jagp.2024.06.007

Nafiz Mosharraf M.D. , Tanya Peguero Estevez M.D. , Lisa J. Cohen Ph.D. , Melinda Lantz M.D.

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引用次数: 0

摘要

目的：本研究比较了使用长效注射型抗精神病药物（LAI-AP）和口服型抗精神病药物（PO-AP）的老年人的人口统计学特征、临床特征和治疗效果：本研究比较了使用长效注射型抗精神病药物（LAI-AP）和口服型抗精神病药物（PO-AP）的老年人的人口统计学、临床特征和治疗效果：设计：这项回顾性队列观察研究利用电子病历搜索引擎查阅了两年内服用 LAI-AP 的老年患者的病历。使用 PO-AP 的方便样本组成对比组。LAI-AP患者被细分为停药组和继续用药组：在一家城市精神科门诊进行，使用 2020 年 10 月至 2022 年的病历：研究期间至少服用 3 个月抗精神病药物的 60 岁以上精神病或情绪障碍患者：收集PO-AP组和LAI-AP组的人口统计学和临床变量，包括诊断、药物类型、副作用、医疗合并症、神经认知状态和辅助药物。结果变量包括失约、精神和医疗住院以及急诊就诊。此外，还评估了停用LAI-AP的相关因素：与 PO-AP 相比，LAI-AP 患有原发性精神病的比例更高（87.8% 对 64.3%）。在研究期间，PO-AP的失约率（中位数为18%，而LAI-AP为13%）和精神病入院率（平均为0.019/月，而LAI-AP为0.006/月）均高于LAI-AP；女性性别是停用LAI-AP的风险因素（停用组为86.7%，而继续使用组为55.2%）：结论：LAI-AP治疗组减少了住院次数，治疗参与度更高，耐受性与PO-AP相当。初步数据表明，性别可能会影响LAI-AP的停药率。这项研究为研究老年患者LAI-AP疗效和耐受性的稀少文献增添了新的内容。

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Long-Acting Injectable Antipsychotics in the Geriatric Population: A longitudinal Study

Objective

This study compares demographic, clinical characteristics, and outcomes in older adults on long-acting injectable antipsychotics (LAI-AP) vs. oral antipsychotics (PO-AP).

Design

This observational study with a retrospective cohort utilized the electronic medical record's search engine to review charts of geriatric patients on LAI-AP for a two-year period. A convenience sample on PO-AP formed the comparison group. LAI-AP patients were subcategorized into discontinuation and continuation groups.

Setting

Conducted at an urban, psychiatric outpatient clinic, using charts from October 2020 to 2022.

Participants

Patients at least 60 years-old with psychotic or mood disorders on antipsychotics for at least 3-months during the study period.

Measurements

Demographic and clinical variables, including diagnosis, medication type, side effects, medical comorbidities, neurocognitive status, and secondary medications, were collected for both PO-AP and LAI-AP groups. Outcome variables included missed appointments, psychiatric and medical hospitalizations, and emergency room visits. Correlates of discontinuation of LAI-AP were also assessed.

Results

LAI-AP had a higher proportion than PO-AP of primary psychotic disorders (87.8% vs. 64.3%). During the study, PO-AP had higher rates of missed appointments (median 18% vs. 13% for LAI-AP) and psychiatric admissions (mean 0.019/month vs. 0.006/month for LAI-AP;); Female sex was a risk factor for discontinuation of LAI-AP (86.7% of discontinuation group vs. 55.2% of continuation group).

Conclusions

The LAI-AP group showed reduced hospitalizations, better treatment engagement, and comparable tolerability to PO-AP. Preliminary data suggests gender may influence LAI-AP discontinuation rates. This study adds to the sparse literature investigating the efficacy and tolerability of LAI-AP in geriatric patients.

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来源期刊

American Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

13.00

自引率

4.20%

发文量

381

审稿时长

26 days

期刊介绍： The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.