Deprescribing antipsychotics in long term care patients with dementia

Patricia Bravo-José; Carmen Isabel Sáez-Lleó; Juan Francisco Peris-Martí

doi:10.7399/fh.11217

Deprescribing antipsychotics in long term care patients with dementia

Patricia Bravo-José, Carmen Isabel Sáez-Lleó, Juan Francisco Peris-Martí

Resumen

Objetivo: Elaborar un protocolo de uso de fármacos antipsicóticos en pacientes institucionalizados que presenten alteraciones conductuales que incluya criterios de prescripción y deprescripción y valorar su aplicabilidad en el ámbito de los centros sociosanitarios.

Método: El protocolo de actuación se elaboró por consenso de un equipo interdisciplinar a partir de una búsqueda bibliográfica de las propuestas publicadas sobre el uso de antipsicóticos en estos pacientes. La valoración de su aplicabilidad en la desprescripción de antipsicóticos se realizó mediante un estudio prospectivo antes-después con un seguimiento de 6 meses tras la intervención en una residencia para personas mayores dependientes.

Resultados: Se elaboró un protocolo que incluye criterios de prescripción y desprescripción de antipsicóticos. La intervención se realizó sobre 35 pacientes, 21 (60%) de las cuales eran mujeres. La retirada del tratamiento antipsicótico fue completa en 28 pacientes (80%) y se redujo a la mínima dosis eficaz en 7 (20%). El tratamiento se reinició en 2 pacientes por agravamiento de los síntomas. Los resultados de la evaluación conductual previa y a los 6 meses indicaron que no se produjeron modificaciones significativas en dichas alteraciones (12,91 ± 12,80 frente a 13,76 ± 16,68; p = 0,124).

Conclusiones: El establecimiento de un protocolo que incluya criterios de prescripción y desprescripción, unido a la incorporación del farmacéutico en el equipo interdisciplinar, puede ser una herramienta eficaz para mejorar el uso de este tipo de medicamentos en los pacientes institucionalizados con demencia.

Palabras clave

Antipsicóticos; Deprescripción; Síntomas conductuales; Enfermedad de Alzheimer; Demencia; Centro sociosanitario

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Referencias

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DOI: http://dx.doi.org/10.7399%2Ffh.11217