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

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