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黑人和白人住院患者的抗精神病药物处方情况。

Antipsychotic prescribing in Black and White hospitalised patients.

作者信息

Connolly Anne, Taylor David, Sparshatt Anna, Cornelius Victoria

机构信息

Pharmacy Department, Maudsley Hospital, London, UK.

出版信息

J Psychopharmacol. 2010 Dec 8. doi: 10.1177/0269881110387841.

Abstract

Ethnicity may affect the prescribing of antipsychotic treatment. Previous UK studies conducted in south London have found few differences in antipsychotic prescribing quality for Black and White patients. This larger multicentre study examined the effect of ethnicity on antipsychotic prescribing quality in areas serving the largest proportions of Black patients in the UK. A cross-sectional survey with collection of multiple confounding factors potentially affecting outcomes in eight secondary care units in England over a three month period. Participants were Black or White inpatients prescribed regular antipsychotics on the day of the survey. Antipsychotic dose (expressed as a percentage of licensed maximum), high dose (being prescribed antipsychotic medication above maximum dose), polypharmacy (more than one antipsychotic prescribed), type (typical or atypical antipsychotic) and costs were the main outcome measures. Data were collected for 938 patients. There were no significant differences in any outcome by ethnicity: dose (adjusted percentage difference 0.97 [95% confidence interval (CI) -4.28, 6.22], p = 0.72); high dose (adjusted odds ratio (AOR) 0.98 [CI 0.63, 1.51], p = 0.92); polypharmacy prescribed (AOR 1.15 [CI 0.87, 1.51], p = 0.33); polypharmacy administered (AOR 1.08 [CI 0.78, 1.49], p = 0.66); use of typical antipsychotics (AOR 1.25 [CI 0.87, 1.79], p = 0.22); and cost (adjusted effect size 1.75 [CI -9.81, 13.31], p = 0.77). Antipsychotic prescribing practice did not differ between Black and White patients.

摘要

种族可能会影响抗精神病药物治疗的处方。此前在伦敦南部进行的英国研究发现,黑人和白人患者在抗精神病药物处方质量方面几乎没有差异。这项规模更大的多中心研究考察了种族对英国黑人患者比例最高地区抗精神病药物处方质量的影响。在三个月的时间里,对英格兰八个二级医疗机构进行了一项横断面调查,收集了多个可能影响结果的混杂因素。研究对象为调查当天正在服用常规抗精神病药物的黑人和白人住院患者。抗精神病药物剂量(以许可最大剂量的百分比表示)、高剂量(开具的抗精神病药物高于最大剂量)、联合用药(开具一种以上抗精神病药物)、类型(典型或非典型抗精神病药物)和费用是主要的结局指标。收集了938名患者的数据。种族在任何结局方面均无显著差异:剂量(调整后的百分比差异为0.97 [95%置信区间(CI)-4.28,6.22],p = 0.72);高剂量(调整后的优势比(AOR)为0.98 [CI 0.63,1.51],p = 0.92);开具联合用药(AOR 1.15 [CI 0.87,1.51],p = 0.33);使用联合用药(AOR 1.08 [CI 0.78,1.49],p = 0.66);使用典型抗精神病药物(AOR 1.25 [CI 0.87,1.79],p = 0.22);以及费用(调整后的效应量为1.75 [CI -9.81,13.31],p = 0.77)。黑人和白人患者在抗精神病药物处方实践方面没有差异。

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