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上海市焦虑障碍患者门诊服药依从性现况调查
作者:杨旭娇  宋立升 
单位:上海交通大学医学院附属精神卫生中心  上海 200030 
关键词:焦虑障碍|门诊|服药依从性|现况调查 
分类号:R395.2
出版年,卷(期):页码:2018,26(1):86-88
摘要:

目的:调查焦虑障碍患者门诊用药的依从情况,同时探讨各临床特征患者药物依从性之间的差异,为医生制定治疗方案及预测疾病转归提供依据。方法:利用上海市精神卫生中心门诊电子信息系统抽取2011年1月1日-2014年12月31日在门诊确诊为焦虑障碍并首次口服抗焦虑药物治疗的患者,以药物持有率(Medication Posses-sion Ration,MPR)量化患者在随访期内的药物依从性。结果:本研究共纳入患者19,789例,其中男性患者7,965(40.2%)例,女性患者11,824(59.8%)例,年龄18岁~98岁,平均(47±17岁)。随访期内患者的MPR随着时间的推移不断降低,研究开始3个月、6个月、9个月、12个月内患者MPR值分别为0.98(±1.19)、0.67(±0.90)、0.54(±0.78)、0.46(±0.72);12个月的随访期内只有27.8%(N=5,503)的患者MPR值大于0.5,19.0%(N=3,765)的患者MPR值大于0.8。其中,精神科门诊及心理咨询门诊患者的年MPR值分别为0.51(±0.72)、0.42(±0.69);男性患者及女性患者的年MPR值分别为0.45(±0.70)、0.46(±0.70);青年、中年及老年患者的年MPR值分别为0.40(±0.62)、0.47(±0.81)、0.54(±0.72);广泛性焦虑、惊恐障碍、社交恐怖症患者的年MPR值分别为0.45(±0.71)、0.61(±0.79)、0.37(±0.77);单药治疗及联药治疗患者的年MPR值分别为0.34(±0.56)、0.51(±0.75);首次用药选用5-羟色胺再摄取抑制剂(SSRIs)、5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs)及其他具有抗焦虑作用精神药物患者的年MPR分别为0.46(±0.69)、0.49(±0.67)、0.43(±0.73)。结论:焦虑障碍患者的药物依从性较低,且各临床特征患者之间药物依从性差异较大。

Objective:To investigate the medication adherence of outpatients with anxiety disorder and the difference between patients dissimilitude in demography or clinical features. Methods:Data were obtained from the outpatient elec-tric information system of Shanghai Mental Health Center and the study started at the first time when the patients took Anx-iolytic drugs from 2011 to 2014. Adherence was measured with a medication possession ratio(MPR). Results:A total of 19, 789 patients with anxiety disorder were enrolled. Among all the patients, 7,965(40.2%) were male and 11,824(59.8%) were female. The average age was 47(±17) years old. Along with the increase of age, MPR of patients decreased. The mean MPR was 0.98(±1.19), 0.67(±0.90), 0.54(±0.78), 0.46(±0.72) on the 3rd month, the 6th month, the 9th month and the 12th month during the follow-up period respectively. Only 27.8%(N=5,503) of patients with MPR ≥ 0.5, 19.0%(N=3,765) of patients with MPR ≥ 0.5 were found during the 12-month follow-up. The annual MPR value of patients with psychiatric outpatient and psychological consultation was 0.51(±0.72) and 0.42(±0.69), respectively; The MPR values of male and female patients were 0.45(±0.70) and 0.46(±0.70); The annual MPR value of young, middle-aged and elderly patients was 0.40(±0.62), 0.47 (±0.81), 0.54(±0.72); The annual MPR values of patients with generalized anxiety, panic disorder and social phobia were 0.45(±0.71), 0.61(±0.79), 0.37(±0.77), respectively; The MPR values of patients treated with monotherapy and combined therapy were 0.34(±0.56) and 0.51(±0.75); First dose selection serotonin reuptake inhibitors(SSRIs), 5-serotonin norepi-nephrine reuptake inhibitors(SNRIs) and other psychotropic drugs in patients in MPR were 0.46(±0.69), 0.49(±0.67), 0.43(±0.73). Conclusion:The medication adherence of anxiety disorder is low, which may be influenced by different clinical char-acteristics.

基金项目:
上海市科委医学引导类项目(15401934300)
作者简介:
参考文献:

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