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初级保健中为西班牙裔和非西班牙裔白人患者开具抗抑郁药的情况。

Antidepressant prescribing to Hispanic and non-Hispanic white patients in primary care.

作者信息

Sleath B L, Rubin R H, Huston S A

机构信息

School of Pharmacy and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 27599-7360, USA.

出版信息

Ann Pharmacother. 2001 Apr;35(4):419-23. doi: 10.1345/aph.10245.

Abstract

OBJECTIVE

To examine whether there was a difference in the prescribing of selective serotonin-reuptake inhibitors (SSRIs) and non-SSRI antidepressants to Hispanic and non-Hispanic white patients in primary care.

METHODS

Twenty-seven family practice and internal medicine resident physicians and 407 of their Hispanic and non-Hispanic white patients who were fluent in English or Spanish participated in the study The medical records of all patients were reviewed and information about patient diagnoses and antidepressant prescriptions was abstracted. Logistic regression was used to examine whether Hispanic ethnicity influenced physician prescribing of SSRI and non-SSRI antidepressants while controlling for other patient characteristics and diagnoses. For patients with a diagnosis of depression, logistic regression was used to examine whether Hispanic ethnicity influenced whether patients received antidepressant treatment while controlling for other patient characteristics

RESULTS

Twenty-seven percent of patients received a prescription for one or more antidepressants. Hispanic and non-Hispanic white patients were equally likely to be prescribed SSRI and non-SSRI antidepressant medications. Having a diagnosis of depression and having a diagnosis of chronic pain was significantly correlated with the prescribing of a non-SSRI antidepressant (p < 0.001, p < 0.01, respectively). Having a diagnosis of depression was significantly correlated with the prescribing of an SSRI antidepressant (p < 0.001). Hispanic and non-Hispanic white patients with a diagnosis of depression were equally likely to be prescribed antidepressant treatment. Patients with a diagnosis of depression in the general medicine clinic were significantly less likely to receive antidepressant therapy than patients in the family practice clinic.

CONCLUSIONS

Hispanic ethnicity did not influence antidepressant prescribing. Future research in other settings is needed to further determine whether Hispanic ethnicity influences antidepressant prescribing.

摘要

目的

研究在初级医疗中,西班牙裔患者与非西班牙裔白人患者在选择性5-羟色胺再摄取抑制剂(SSRI)及非SSRI类抗抑郁药的处方上是否存在差异。

方法

27名家庭医学和内科住院医师及其407名能流利使用英语或西班牙语的西班牙裔和非西班牙裔白人患者参与了该研究。研究人员查阅了所有患者的病历,并提取了有关患者诊断和抗抑郁药处方的信息。在控制其他患者特征和诊断的同时,采用逻辑回归分析来研究西班牙裔种族是否会影响医生对SSRI和非SSRI类抗抑郁药的处方。对于被诊断为抑郁症的患者,在控制其他患者特征的同时,采用逻辑回归分析来研究西班牙裔种族是否会影响患者是否接受抗抑郁治疗。

结果

27%的患者接受了一种或多种抗抑郁药的处方。西班牙裔患者和非西班牙裔白人患者被开具SSRI和非SSRI类抗抑郁药的可能性相同。被诊断为抑郁症和慢性疼痛与开具非SSRI类抗抑郁药显著相关(分别为p < 0.001,p < 0.01)。被诊断为抑郁症与开具SSRI类抗抑郁药显著相关(p < 0.001)。被诊断为抑郁症的西班牙裔患者和非西班牙裔白人患者接受抗抑郁治疗的可能性相同。综合内科门诊中被诊断为抑郁症的患者接受抗抑郁治疗的可能性显著低于家庭医学门诊的患者。

结论

西班牙裔种族不影响抗抑郁药的处方。需要在其他环境中进行进一步研究,以进一步确定西班牙裔种族是否会影响抗抑郁药的处方。

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