Machado-Alba Jorge E, Morales Plaza Cristhian David, Solarte Gómez Mónica Johanna
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Departamento de Ciencias Básicas, Universidad Tecnológica de Pereira, Pereira, Colombia.
Rev Panam Salud Publica. 2011 Nov;30(5):461-8. doi: 10.1590/s1020-49892011001100009.
Determine patterns of antidepressive drug prescription in a group of patients affiliated with the General Social Security Health System in Colombia.
Observational descriptive study of 9 881 patients, of both sexes and older than 5 years of age, medicated with antidepressants and continuously treated from August to October 2009. The patients include residents from 56 Colombian cities. A database was designed based on the consumption of medicines obtained from the company that distributes them to the patients.
The average age was 59.1 ± 16.1 years; 73.7% of the participants were women. Of the total number of patients, 83.3% were treated with monotherapy and 16.7% with two or more antidepressants. The order of the prescription of the medicines was: selective serotonin reuptake inhibitors, 47.0%; atypical, 37.8%; tricyclical, 31.8%; selective serotonin reuptake inhibitors and norepinephrine, 1.8%; and selective norepinephrine reuptake inhibitors, 0.03%. The combinations most used were fluoxetine + trazodone (n = 1 029); amitriptyline + fluoxetine (n = 265); amitriptyline + trazodone (n = 122); fluoxetine + imipramine (n = 106); and imipramine + trazodone (n = 71). The most prescribed co-medications were anti-hypertensives (52.3%); thyroid hormones (23.3%); anti-inflammatories (19.6%); anti-epileptics (15.4%); anti-diabetics (13.8%); anti-anxiety and hypnotics (12.4%); antipsychotics (7.4%); anti-Parkinsons (4.3%); and anti-neoplastics (2.2%).
The practice of prescribing medicines with a high therapeutic value predominates, mainly for antidepressive monotherapy. Most of the antidepressants are prescribed at dosages lower than those recommended. There is a need to design educational strategies to correct some prescription practices and to conduct research.
确定哥伦比亚综合社会保障卫生系统所属一组患者的抗抑郁药物处方模式。
对9881名年龄在5岁以上的男女患者进行观察性描述性研究，这些患者在2009年8月至10月期间服用抗抑郁药物并持续接受治疗。患者包括来自哥伦比亚56个城市的居民。根据从向患者分发药物的公司获得的药品消费情况设计了一个数据库。
平均年龄为59.1±16.1岁；73.7%的参与者为女性。在所有患者中，83.3%接受单一疗法治疗，16.7%接受两种或更多种抗抑郁药物治疗。药物处方顺序为：选择性5-羟色胺再摄取抑制剂，47.0%；非典型药物，37.8%；三环类药物，31.8%；选择性5-羟色胺再摄取抑制剂和去甲肾上腺素，1.8%；以及选择性去甲肾上腺素再摄取抑制剂，0.03%。最常用的联合用药是氟西汀+曲唑酮（n = 1029）；阿米替林+氟西汀（n = 265）；阿米替林+曲唑酮（n = 122）；氟西汀+丙咪嗪（n = 106）；以及丙咪嗪+曲唑酮（n = 71）。最常开的辅助药物是抗高血压药（52.3%）；甲状腺激素（23.3%）；抗炎药（19.6%）；抗癫痫药（15.4%）；抗糖尿病药（13.8%）；抗焦虑和催眠药（12.4%）；抗精神病药（7.4%）；抗帕金森病药（4.3%）；以及抗肿瘤药（2.2%）。
以高治疗价值药物开处方的做法占主导，主要用于抗抑郁单一疗法。大多数抗抑郁药物的处方剂量低于推荐剂量。需要设计教育策略来纠正一些处方做法并开展研究。
