Lachaux B, Casadebaig F, Philippe A, Ardiet G
Hôpital P. Guiraud, 94806 Villejuif.
Encephale. 2004 Jan-Feb;30(1):46-51. doi: 10.1016/s0013-7006(04)95415-2.
The two cross-sectional surveys reported here concern the field of pharmaco-epidemiology of prescription practices. The objective is to describe and understand these practices in regard to antipsychotics and their evolution in all indications which go beyond the field of psychotic pathology. The research presented here only concerns schizophrenic pathology.
These 2 cross-sectional surveys were carried out in public psychiatric sectors in 1995 and 1998 applying the same methodology in the same services. On a given day, in each sector, they concern all patients aged from 18 to 64 and receiving an antipsychotic prescription. A hospital unit and a consultation unit were included to take into account practices which could be different in these two places of care. A comparison was made between the 1995 stage and the 1998 one for a better understanding of evolution in practical terms. An unvaried analysis was carried out to test the differences observed between 1995 and 1998 as well as a correlation test to evaluate evolution according to age and duration.
The main results were as follows: the number of antipsychotics slightly decreased significantly from 1.74 (+/- 0.02) in the 1995 survey to 1.69 (+/- 0.04) in the 1998 one (p<0.05); the number of patients receiving antiparkinsonian medicines, correcting extra pyramidal effects, decreased from 60% in 1995 to 50% in 1998. The following associated factors were noted concerning prescription of antipsychotics. Women received a mean number of antipsychotics significantly lower than that of men. For each sex the mean number was lower in the 1998 survey, but not significantly so. In the two surveys, there was a positive correlation between the mean number of antipsychotics and age; it increased as the patient grew older. The mean number of antipsychotics tended to increase significantly with length of illness, in 1995 as well as in 1998. It was for the shortest periods that the mean number of antipsychotics was lowest. The mean number of antipsychotics was significantly higher in the hospital field as compared to the ambulatory. The greater was the mean number of antipsychotics, the greater was the proportion of patients who received antiparkinsonian medication. Firstly, these surveys shed light on what may underlie prescription practices such as sex and age of the patient, length of illness and the place of care. Secondly, the evolution of practices in time can be followed, taking into account the increase of knowledge concerning this subject.
此处报告的两项横断面调查涉及处方实践的药物流行病学领域。目的是描述和理解抗精神病药物的这些实践及其在超出精神病病理学领域的所有适应症中的演变。此处呈现的研究仅涉及精神分裂症病理学。
这两项横断面调查于1995年和1998年在公共精神科部门进行，在相同的科室采用相同的方法。在给定的一天，在每个科室，调查对象为所有年龄在18至64岁且正在接受抗精神病药物处方的患者。纳入了一个医院病房单元和一个咨询单元，以考虑这两个护理场所可能不同的实践情况。对1995年阶段和1998年阶段进行比较，以便更好地从实际角度理解演变情况。进行了单变量分析以检验1995年和1998年之间观察到的差异，并进行了相关性检验以评估根据年龄和病程的演变情况。
主要结果如下：抗精神病药物的数量从1995年调查中的1.74（±0.02）略有显著下降至1998年的1.69（±0.04）（p<0.05）；接受抗帕金森药物以纠正锥体外系反应的患者数量从1995年的60%降至1998年的50%。关于抗精神病药物处方，注意到以下相关因素。女性接受的抗精神病药物平均数量显著低于男性。对于每种性别，1998年调查中的平均数量较低，但差异不显著。在两项调查中，抗精神病药物的平均数量与年龄之间存在正相关；随着患者年龄增长而增加。在1995年和1998年，抗精神病药物的平均数量均倾向于随着病程长度显著增加。在病程最短的时期，抗精神病药物的平均数量最低。与门诊相比，医院领域的抗精神病药物平均数量显著更高。抗精神病药物的平均数量越高，接受抗帕金森药物治疗的患者比例就越高。首先，这些调查揭示了处方实践背后可能存在的因素，如患者的性别和年龄、病程长度以及护理场所。其次，考虑到关于该主题的知识增加，可以追踪实践随时间的演变情况。
