Opolka Jayme L, Rascati Karen L, Brown Carolyn M, Barner Jamie C, Johnsrud Michael T, Gibson P Joseph
Eli Lilly and Company, Indianapolis, Ind. 46214, USA.
J Clin Psychiatry. 2003 Jun;64(6):635-9. doi: 10.4088/jcp.v64n0603.
Culture and ethnicity have been suggested to influence the presentation of patients with schizophrenia. These factors are thought to affect the diagnoses, courses of treatment, and medical utilization patterns of patients with schizophrenia. Specifically, the differences between whites, African Americans, and Mexican Americans are of particular importance, as these groups comprise the majority of the population in the United States today. The traditional course of treatment for many patients with schizophrenia is the drug haloperidol. However, research has shown that some ethnic groups (African Americans and Mexican Americans) may respond better to atypical drugs, such as olanzapine, but may be less likely to receive these drugs. A better response to the course of treatment results in improved medical utilization patterns. The purpose of this study was to examine if ethnicity helped predict whether Texas Medicaid patients were prescribed haloperidol versus olanzapine when other factors were controlled for.
The study population consisted of 726 patients whose index drug was haloperidol and 1875 patients whose index drug was olanzapine. Patients had an ICD-9-CM diagnosis of schizophrenia or schizoaffective disorder. Texas medical and prescription claims data were used in a logistic regression analysis to determine significant predictors of the type of antipsychotic (haloperidol vs. olanzapine) patients were prescribed. Variables included in the analysis were ethnicity, gender, age, region, other mental illness comorbidities, and previous utilization of medications and resources. Data were collected from Jan. 1, 1996, to Aug. 31, 1998.
The results show that when other demographic and utilization factors were controlled for, African Americans were less likely than whites to receive olanzapine rather than haloperidol.
Ethnicity is a significant predictor of the type of antipsychotic that is prescribed.
文化和种族被认为会影响精神分裂症患者的临床表现。这些因素被认为会影响精神分裂症患者的诊断、治疗过程和医疗使用模式。具体而言，白人、非裔美国人和墨西哥裔美国人之间的差异尤为重要，因为这些群体构成了当今美国的大部分人口。许多精神分裂症患者的传统治疗方法是使用氟哌啶醇药物。然而，研究表明，一些种族群体（非裔美国人和墨西哥裔美国人）可能对非典型药物（如奥氮平）反应更好，但接受这些药物的可能性较小。对治疗过程的更好反应会改善医疗使用模式。本研究的目的是在控制其他因素的情况下，检验种族是否有助于预测德克萨斯州医疗补助患者被开具氟哌啶醇还是奥氮平。
研究人群包括726名索引药物为氟哌啶醇的患者和1875名索引药物为奥氮平的患者。患者的国际疾病分类第九版临床修订本（ICD - 9 - CM）诊断为精神分裂症或分裂情感性障碍。德克萨斯州的医疗和处方报销数据用于逻辑回归分析，以确定患者被开具的抗精神病药物类型（氟哌啶醇与奥氮平）的显著预测因素。分析中纳入的变量包括种族、性别、年龄、地区、其他精神疾病共病情况以及先前的药物和资源使用情况。数据收集时间为1996年1月1日至1998年8月31日。
结果表明，在控制其他人口统计学和使用因素后，非裔美国人比白人接受奥氮平而非氟哌啶醇的可能性更小。
种族是所开具抗精神病药物类型的一个重要预测因素。
