抗痴呆药物和抗精神病药物同时使用的模式:基于HIRA-APS-2018数据的分析

Hea-Lim Kim, Hye-Jae Lee
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摘要

在韩国,痴呆症患者的数量和由此带来的社会经济负担正在迅速增加。痴呆症的行为和心理症状增加了照顾者的负担,从而主要促使他们入住养老院。本研究利用2018年健康保险审查与评估服务老年患者样本(HIRA-APS)数据,调查痴呆患者同时使用抗痴呆和抗精神病药物的模式,并确定相关因素。多奈哌齐-喹硫平(52.8%)、多奈哌齐-美刚-喹硫平(13.8%)和多奈哌齐-利培酮(8.8%)是使用频率最高的联合用药。Logistic回归分析显示,男性患者、年龄≥75岁、医疗救助受益人和Charlson合并症指数(CCI)≥5的患者更容易接受合并用药。在护理医院或综合医院就诊的患者患此病的可能性增加,而在三级医院就诊的患者患此病的可能性降低。与首都圈相比,湖南、庆尚北道、忠清地区的同时使用可能性更低。本研究结果为进一步研究痴呆患者同时用药的疗效提供了基础依据。
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Patterns of the Concurrent Use of Anti-dementia Drugs and Antipsychotics: Analysis using HIRA-APS-2018 Data
The number of dementia patients and the associated socio-economic burden are rapidly increasing in Korea. Behavioral and psychological symptoms of dementia increase the burden on caregivers, thus primarily instigating admission to a nursing home. In this study, using 2018 Health Insurance Review and Assessment Service-Aged Patient Sample (HIRA-APS) data, the pattern of concurrent use of anti-dementia and antipsychotic drugs by dementia patients was investigated, and related factors were identified. The most frequently used combination were donepezil-quetiapine (52.8%), donepezil-memantine-quetiapine (13.8%), and donepezil-risperidone (8.8%). Logistic regression analysis revealed male patients, those aged ≥75 years, medical aid beneficiaries, and those with Charlson Comorbidity Index (CCI) ≥5 to be more likely to receive concomitant administration. The likelihood increased in patients visiting nursing or general hospitals, while it decreased in patients visiting tertiary hospitals. Honam, Gyeongsang, and Chungcheong regions showed lower likelihood of concurrent use than Seoul-metropolitan area. The results of this study provide basic evidence for further studies on the outcome of concurrent use in dementia patients.
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