精神障碍药物治疗中的指南依从性：一项多中心医院观察性研究。

Guideline adherence in medication management of psychotic disorders: an observational multisite hospital study.

作者信息

Weinmann S, Janssen B, Gaebel W

机构信息

Department of Psychiatry and Psychotherapy, Heinrich Heine University, Duesseldorf, Germany. stefan.weinmann.de

出版信息

Acta Psychiatr Scand. 2005 Jul;112(1):18-25. doi: 10.1111/j.1600-0447.2005.00547.x.

DOI:10.1111/j.1600-0447.2005.00547.x

PMID:15952941

Abstract

OBJECTIVE

To evaluate guideline adherence in in-patient medication care of psychotic disorders.

METHOD

A total of 508 persons with psychotic disorders were included in a naturalistic multisite hospital study. Subjects were assessed weekly on mental state, social functioning, socioeconomic factors and medication prescriptions.

RESULTS

In total, 17% of individuals were prescribed antipsychotic dosages above the recommended value. Among those with persistent psychotic symptoms, 73% received insufficient antipsychotic drug management. About 58% of patients with depressive symptoms were not treated according to guidelines, and 53% of patients did not receive adequate management of side-effects from antipsychotic medications. Subjects with more than six previous psychiatric hospitalizations (OR 1.80, CI: 1.05-3.08) and those with a prominent thought disorder (OR 2.28, CI: 1.23-4.23) had a higher likelihood of not being treated according to guidelines.

CONCLUSION

Individuals with chronic and thought-disordered psychosis may be at a higher risk of receiving medication care not supported by guidelines.

摘要

目的

评估住院精神障碍患者药物治疗中对指南的遵循情况。

方法

一项自然主义多中心医院研究纳入了总共508名精神障碍患者。每周对受试者的精神状态、社会功能、社会经济因素和药物处方进行评估。

结果

总体而言，17%的个体所使用的抗精神病药物剂量高于推荐值。在有持续性精神病症状的患者中，73%的患者抗精神病药物管理不足。约58%有抑郁症状的患者未按指南接受治疗，53%的患者未得到抗精神病药物副作用的充分管理。既往有超过6次精神科住院史的受试者（比值比1.80，可信区间：1.05 - 3.08）和有明显思维障碍的受试者（比值比2.28，可信区间：1.23 - 4.23）未按指南接受治疗的可能性更高。