Bianchi Stefano, Bianchini Erica, Scanavacca Paola
Department of Pharmacy, University Hospital of Ferrara, Corso Giovecca 203, 44123 Ferrara, Italy.
BMC Clin Pharmacol. 2011 Dec 20;11:21. doi: 10.1186/1472-6904-11-21.
This study aimed at describing the type and dosage of psychopharmaceuticals dispensed to patients with psychiatric disorders and to assess the percentage of patients treated with antipsychotics and antidepressants, the associated therapies, treatment adherence, and dosages used in individuals registered at the Psychiatric Disease Center (PDC), Regional Health Service of Ferrara.
The analysis focused on therapeutic programmes presented to the Department of Pharmacy of the University Hospital of Ferrara of 892 patients treated by the PDC (catchment area of 134605 inhabitants). All diagnoses were made according to International Classification of Diseases (ICD-9). The analysis focused on prescriptions from September 2007 to June 2009. Data on adherence to prescribed therapy have were processed by analysis of variance.
Among the patients 63% were treated with antipsychotics and 40% with antidepressants. Among patients receiving antipsychotics 92% used second-generation antipsychotics (SGAs) whereas the remaining 8% used first generation antipsychotics (FGAs). Antipsychotic doses were lower than Daily Defined Dose (DDDs), and SGAs were often given with anticholinergics to decrease side effects. Mean adherence to antipsychotic therapy was 64%. Among antidepressants, selective serotonin reuptake inhibitors (SSRIs) were the most often prescribed, 55%. Dosages of these were within the limits indicated by the technical datasheet but higher than DDDs. Only 26% of patients underwent monotherapy. In antidepressants polytherapy, medication was associated with another antidepressant, 6% or with an antipsychotic, 51%. Mean adherence to the antidepressant therapy was 64%.
Patients treated with antipsychotics tend to use doses lower than DDDs. The opposite tendency was noted in patients treated with antidepressants. Only a small percentage of patients (14%) modified their neuroleptic therapy by increasing the dosage. On the contrary, patients treated with antidepressants mainly tended to reduce the doses of their drugs. This study highlights the tendency to follow combination therapies, prescribing SGAs together with anticholinergics in order to minimize extrapyramidal side effects or by combining two antidepressants. The study showed low adherence for both pharmaceutical therapies, which is typical in the setting of the analyzed diseases.
本研究旨在描述配发给精神疾病患者的精神药物类型和剂量，并评估在费拉拉地区卫生服务中心精神疾病中心（PDC）登记的患者中接受抗精神病药物和抗抑郁药物治疗的患者百分比、相关治疗方法、治疗依从性以及所用剂量。
分析聚焦于费拉拉大学医院药房提交的由PDC治疗的892例患者（服务人口134605）的治疗方案。所有诊断均依据国际疾病分类（ICD - 9）。分析集中于2007年9月至2009年6月的处方。通过方差分析处理规定治疗的依从性数据。
患者中63%接受抗精神病药物治疗，40%接受抗抑郁药物治疗。在接受抗精神病药物治疗的患者中，92%使用第二代抗精神病药物（SGA），其余8%使用第一代抗精神病药物（FGA）。抗精神病药物剂量低于每日限定剂量（DDD），且SGA常与抗胆碱能药物联用以减少副作用。抗精神病药物治疗的平均依从性为64%。在抗抑郁药物中，选择性5 - 羟色胺再摄取抑制剂（SSRI）是最常处方的药物，占55%。这些药物的剂量在技术数据表所示范围内，但高于DDD。仅26%的患者接受单一疗法。在抗抑郁药物联合治疗中，药物与另一种抗抑郁药物联用的占6%，与抗精神病药物联用的占51%。抗抑郁药物治疗的平均依从性为64%。
接受抗精神病药物治疗的患者倾向于使用低于DDD的剂量。接受抗抑郁药物治疗的患者则呈现相反趋势。只有一小部分患者（14%）通过增加剂量调整其抗精神病药物治疗。相反，接受抗抑郁药物治疗的患者主要倾向于减少药物剂量。本研究突出了联合治疗的趋势，将SGA与抗胆碱能药物联用以便将锥体外系副作用降至最低，或联合使用两种抗抑郁药物。该研究显示两种药物治疗的依从性均较低，这在所分析疾病的背景中很典型。
