Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201-2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada.
Psychiatr Serv. 2011 Sep;62(9):1026-31. doi: 10.1176/ps.62.9.pss6209_1026.
This study examined ethnic disparities in antipsychotic therapy in a population with significant Asian representation.
Using a cross-sectional retrospective study design, self-reported ethnicity data pooled from three cycles of the Canadian Community Health Survey were linked to 2005 administrative data on physician, hospital, and pharmaceutical use in British Columbia, Canada. Logistic regression was used to model the association between ethnicity and the likelihood of filling one or more prescriptions for any antipsychotic, with controls for sex, age, residence, immigrant status, income, health status, and diagnoses of schizophrenia, bipolar disorder, depression, and dementia.
Of the 27,658 individuals in the sample, 2.2% filled at least one antipsychotic prescription. The proportion varied across ethnic groups: Chinese, 1.0%; other Asians, 1.2%; whites, 2.3%; nonwhite non-Asians, 2.8%; and mixed ethnicity, 4.3%. After adjustment for patient characteristics and diagnoses of schizophrenia and bipolar disorder, the likelihood of filling a prescription was found to be lower among Chinese (odds ratio [OR] = .47, 95% confidence interval [CI] = .24-.90) and higher among persons of mixed ethnicity (OR = 3.19, CI = 1.49-6.83). Further adjustment for depression and dementia diagnoses did not significantly change the ORs for the Chinese (OR = .49, CI = .25-.98) and the mixed ethnic groups (OR = 2.97, CI = 1.30-6.80).
Consistent with the existing literature on ethnic disparities in antipsychotic therapy, the study found evidence of persistent disparities in a population that has a significant number of Asians. Further studies should be done to identify possible causes of these disparities and to identify potential interventions that may reduce or eliminate them.
本研究旨在检查一个有大量亚洲人代表性的人群中抗精神病药物治疗的种族差异。
采用横断面回顾性研究设计，从加拿大社区健康调查的三个周期中汇总了自我报告的种族数据，并将其与 2005 年不列颠哥伦比亚省医生、医院和药物使用的行政数据进行了关联。使用逻辑回归模型来模拟种族与填写一份或多份任何抗精神病药物处方的可能性之间的关联，同时控制了性别、年龄、居住地、移民身份、收入、健康状况以及精神分裂症、双相情感障碍、抑郁症和痴呆症的诊断。
在样本中的 27658 人中，有 2.2%的人至少填写了一份抗精神病药物处方。不同种族群体的比例有所不同：中国人为 1.0%；其他亚洲人为 1.2%；白人为 2.3%；非白种非亚洲人为 2.8%；混合种族为 4.3%。在调整了患者特征和精神分裂症及双相情感障碍的诊断后，发现中国人填写处方的可能性较低（比值比 [OR] =.47，95%置信区间 [CI] =.24-.90），而混合种族的人填写处方的可能性较高（OR = 3.19，CI = 1.49-6.83）。进一步调整抑郁症和痴呆症的诊断并没有显著改变中国人（OR =.49，CI =.25-.98）和混合种族（OR = 2.97，CI = 1.30-6.80）的比值比。
与现有的抗精神病药物治疗种族差异的文献一致，本研究在一个有大量亚洲人的人群中发现了持续存在的种族差异的证据。应该进一步研究这些差异的可能原因，并确定可能减少或消除这些差异的潜在干预措施。
