TREATMENT OF AGITATION IN THE NURSING HOME

在疗养院治疗躁动

• 批准号: 2051431
• 负责人: Jiska Cohen-Mansfield
• 金额: $ 15.98万
• 依托单位: HEBREW HOME OF GREATER WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-08-18 至 1996-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2051431
• 关键词: TREATMENT; AGITATION; NURSING; HOME

Agitation is a major problem for nursing home residents and for their caregivers. It is frequently treated with psychotropic drugs, although their efficacy for agitation has not been conclusive, and the drugs are associated with increased risks of adverse effects. The proposed study aims to explore the effectiveness of psychotropic drugs for the treatment of agitation in nursing home residents through a placebo-controlled, double-blind random assignment, parallel group, trial of withdrawal of medications. The effects of drug withdrawal on levels of agitation, on somatic adverse effects, and on neuropsychological functioning will be examined for three psychotropic drugs: haloperidol, thioridazine, and lorazepam. In addition, the study will explore the following questions: a) Is there a subgroup of residents who appear to benefit from psychotropic drugs? Are they characterized by use of a specific drug? or by type of agitation? or by other resident characteristics? b) Is functioning other than agitation affected by the withdrawal of psychotropic drug use? c) Does the response to withdrawal of these psychotropic drugs change over the course of tapering and withdrawal? Can the final outcome of discontinuation be predicted from an earlier assessment during the tapering phase? For each of the drugs, fifty residents receiving the drug will be randomly divided into two groups: those who continue their medication and those who will gradually receive placebo instead. Residents will be evaluated by nursing staff and by the research team at baseline, a week after beginning of withdrawal, and six weeks after administration of placebo. Drug levels in the blood and prolactin levels will also be assessed at these times. All staff and research personnel will be blind to the medication status until the end of the trial. Since recent OBRA regulations require nursing homes to increase monitoring of psychotropic drugs, and decrease their usage, there is an urgent need to study the impact of withdrawal of these drugs, and the conditions under which they may be effective. The proposed study will address some of these issues.

煽动是疗养院居民及其的主要问题 照顾者。 它经常用精神药物治疗 它们的搅动功效并不是结论性的，药物是 与不利影响风险增加有关。 拟议的研究旨在探索精神疾病的有效性 通过A 安慰剂对照，双盲随机分配，平行组，试验 戒断药物。 药物提取对水平的影响 激动，躯体不良反应和神经心理学 将检查三种精神药物的功能：氟哌啶醇， 硫代嗪和劳拉西m。 此外，该研究将探索 以下问题： a）似乎有一群似乎从中受益的居民 精神药物？它们的特征是使用特定药物吗？或者 按搅拌类型？还是其他居民特征？ b）除了受到撤回影响的躁动外，还起作用 精神药物使用？ c）对这些精神药物的戒断做出回应 在逐渐减少和退出过程中？可以的最终结果 从较早的评估中预测中断 锥度阶段？ 对于每种药物，接受该药物的五十名居民将是 随机分为两组：继续用药的人 那些会逐渐获得安慰剂的人。 居民会 由护理人员和基线研究小组评估，一周 撤回开始后，管理后六周 安慰剂。 血液和催乳素水平的药物水平也将是 在这些时候进行了评估。 所有员工和研究人员将是盲目的 直到审判结束为止。 由于最近的OBRA法规要求养老院增加 监测精神药物，并减少其使用情况，有一个 迫切需要研究戒断这些药物的影响， 它们可能有效的条件。 拟议的研究将 解决其中一些问题。