Gianfrancesco F, Wang R H, Pesa J, Rajagopalan K
HECON Associates, Inc., Montgomery Village, MD 20886, USA.
Int J Clin Pract. 2006 Nov;60(11):1419-24. doi: 10.1111/j.1742-1241.2006.01161.x.
This study used administrative claims data to compare the relative risks for hospitalisation among patients with schizophrenia within a US Medicaid programme receiving atypical and typical antipsychotics. The newer atypical antipsychotics may be better tolerated among mentally ill patients receiving public assistance (Medicaid) who are less functional than other mentally ill populations. Risperidone, olanzapine, quetiapine and ziprasidone were compared with each other and to typical antipsychotics as a single category. Cox proportional hazard estimates, adjusted for differences in patient characteristics, showed numerically lower risks for each of the atypicals in comparison with the typicals, with that for quetiapine being statistically significant (HR: 0.672, p = 0.0413). There were no statistically significant differences among atypical pairs. This study provides evidence that risk for hospitalisation among Medicaid patients with schizophrenia may be lower with atypical antipsychotics, particularly quetiapine.
本研究利用行政索赔数据,比较了美国医疗补助计划中使用非典型和典型抗精神病药物的精神分裂症患者的住院相对风险。在接受公共援助(医疗补助)、功能状况比其他精神病患者群体更差的精神病患者中,新型非典型抗精神病药物的耐受性可能更好。将利培酮、奥氮平、喹硫平和齐拉西酮相互比较,并与作为单一类别看待的典型抗精神病药物进行比较。经患者特征差异调整后的Cox比例风险估计显示,与典型药物相比,每种非典型药物(的住院风险)在数值上都更低,其中喹硫平具有统计学显著性(风险比:0.672,p = 0.0413)。非典型药物两两之间没有统计学显著性差异。本研究提供了证据表明,对于医疗补助计划中的精神分裂症患者,使用非典型抗精神病药物,尤其是喹硫平,住院风险可能更低。