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种族密度、身体疾病、社会剥夺与基层医疗中的抗抑郁药物处方:生态学研究

Ethnic density, physical illness, social deprivation and antidepressant prescribing in primary care: ecological study.

作者信息

Walters Paul, Ashworth Mark, Tylee André

机构信息

Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK.

出版信息

Br J Psychiatry. 2008 Sep;193(3):235-9. doi: 10.1192/bjp.bp.107.038299.

Abstract

BACKGROUND

Antidepressant prescribing should reflect need. The Quality and Outcomes Framework has provided an opportunity to explore factors affecting antidepressant prescribing in UK general practice.

AIMS

To explore the relationship between physical illness, social deprivation, ethnicity, practice characteristics and the volume of antidepressants prescribed in primary care.

METHOD

This was an ecological study using data derived from the Quality and Outcomes Framework, the Informatics Collaboratory of the Social Sciences, and Prescribing Analyses and CosT data for 2004-2005. Associations were examined using linear regression modelling.

RESULTS

Socio-economic status, ethnic density, asthma, chronic obstructive pulmonary disease and epilepsy explained 44% of the variance in the volume of antidepressants prescribed.

CONCLUSIONS

Lower volumes of antidepressants are prescribed in areas with high densities of Black or Asian people. This may suggest disparities in provision of care. Chronic respiratory disease and epilepsy may have a more important association with depression in primary care than previously thought.

摘要

背景

抗抑郁药物的处方应反映实际需求。质量与结果框架提供了一个契机,可用于探究影响英国全科医疗中抗抑郁药物处方的因素。

目的

探讨躯体疾病、社会剥夺、种族、医疗机构特征与基层医疗中抗抑郁药物处方量之间的关系。

方法

这是一项生态学研究,使用的数据来源于质量与结果框架、社会科学信息协作中心以及2004 - 2005年的处方分析与成本数据。采用线性回归模型检验相关性。

结果

社会经济地位、种族密度、哮喘、慢性阻塞性肺疾病和癫痫解释了抗抑郁药物处方量变异的44%。

结论

在黑人或亚洲人高密度聚居地区,抗抑郁药物的处方量较低。这可能表明在医疗服务提供方面存在差异。在基层医疗中,慢性呼吸道疾病和癫痫与抑郁症的关联可能比之前认为的更为重要。

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