Vedia Urgell C, Bonet Monne S, Forcada Vega C, Parellada Esquius N
Servei d'Atenció Primària Mataró-Maresme, ICS, Mataró, Barcelona, Spain.
Aten Primaria. 2005 Sep 30;36(5):239-45. doi: 10.1157/13079144.
To get to know the profile of use of antidepressants (AD) and tranquilizers-hypnotics (T-H) in primary care in Catalonia.
Transversal, observational, epidemiological study of prescription-indication.
Health centres in Catalonia, Spain.
Included, using consecutive sampling, patients on treatment with AD and/or T-H.
The variables studied were: age, sex, type and number of drugs, treatment schemes, reason for prescribing, and the health professional who initiated it.
1613 drugs were evaluated: 43% were AD and 57% were T-H. The sub-groups most prescribed were: selective serotonin reuptake inhibitors (SSRI) (31.6%) and short half-life (32.9%) and long half-life (19.8%) benzodiazepines (BZD). We included 998 patients, 76% of the participants were women. The average age was 52.24 years (range, 16-96). 19.9% (n=199) received treatment with AD only, 34.3% (n=342) with T-H only, and 45.8% (n=457) combined treatment. The mean number of drugs per patient was 1.6. The main reasons for prescribing were: major depression or dysthymia (60.2%; n=417) for AD and generalised anxiety (33.3%; n=306) and insomnia (23.9%; n=220) for T-H. 39.8% (n=268) of the AD and 51.0% (n=441) of T-H had been prescribed for more than 1 year.
The described profile of the use of psychiatric drugs suggests the need to reconsider the over-prescribing of BDZ and improve coordination between psychiatrists and primary care doctors.
了解加泰罗尼亚初级保健中抗抑郁药(AD)和镇静催眠药(T-H)的使用情况。
关于处方指征的横向、观察性流行病学研究。
西班牙加泰罗尼亚的健康中心。
采用连续抽样法,纳入正在接受AD和/或T-H治疗的患者。
所研究的变量包括:年龄、性别、药物类型和数量、治疗方案、处方原因以及开出处方的医疗专业人员。
共评估了1613种药物:43%为AD,57%为T-H。处方最多的亚组为:选择性5-羟色胺再摄取抑制剂(SSRI)(31.6%)以及短效(32.9%)和长效(19.8%)苯二氮䓬类药物(BZD)。我们纳入了998名患者,76%的参与者为女性。平均年龄为52.24岁(范围为16 - 96岁)。19.9%(n = 199)仅接受AD治疗,34.3%(n = 342)仅接受T-H治疗,45.8%(n = 457)接受联合治疗。每位患者的平均药物数量为1.6种。处方的主要原因是:AD用于重度抑郁或心境恶劣(60.2%;n = 417),T-H用于广泛性焦虑(33.3%;n = 306)和失眠(23.9%;n = 220)。39.8%(n = 268)的AD和51.0%(n = 441)的T-H的处方时间超过1年。
所描述的精神药物使用情况表明有必要重新考虑BZD的过度处方问题,并改善精神科医生与初级保健医生之间的协调。