Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, P. R. China.
Pharmacopsychiatry. 2012 Jan;45(1):7-12. doi: 10.1055/s-0031-1286345. Epub 2011 Oct 11.
This study aimed to identify trends in the use of antipsychotic polypharmacy (APP) and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009.
A total of 6,761 schizophrenia inpatients in 9 Asian countries and territories were examined; 2,399 in 2001, 2,136 in 2004, and 2,226 in 2009. Patients’ socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure.
The proportion of APP prescription decreased from 46.8 % in 2001, to 38.3 % in 2004, and increased to 43.4 % in 2009, with wide intercountry variations at each survey. Multiple logistic regression analysis of the whole sample revealed that patients on APP were younger, had a higher dose of antipsychotics in chlorpromazine equivalents, and more severe positive and negative symptoms. They were also more likely to receive depot and fi rst-generation antipsychotic drugs.
The frequency of APP prescription varied between countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining APP use in Asia. To resolve the discrepancy between treatment recommendation and clinical practice, regular reviews of prescription patterns are needed.
本研究旨在探讨 2001 年至 2009 年间亚洲地区抗精神病药联合用药（APP）的使用趋势及其与人口统计学和临床相关因素的关系。
共纳入 9 个亚洲国家和地区的 6761 例住院精神分裂症患者，分别为 2001 年 2399 例，2004 年 2136 例，2009 年 2226 例。采用标准化的方案和数据收集程序记录患者的社会人口学和临床特征以及精神药物的处方情况。
APP 处方的比例从 2001 年的 46.8%下降到 2004 年的 38.3%，并在 2009 年增加到 43.4%，各调查年度之间存在广泛的国家间差异。对所有样本进行的多因素逻辑回归分析显示，应用 APP 的患者年龄较小，使用的抗精神病药以氯丙嗪等效剂量计算的剂量较高，阳性和阴性症状更为严重。他们也更有可能接受长效和第一代抗精神病药物。
APP 处方的频率在不同国家和地区之间存在差异，这表明一系列临床和社会文化因素在决定亚洲地区 APP 的使用中发挥了作用。为了解决治疗建议与临床实践之间的差异，需要定期审查处方模式。
