Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia.
Can J Psychiatry. 2012 Aug;57(8):488-95. doi: 10.1177/070674371205700807.
To examine the essential and potentially inappropriate use of antipsychotics across income groups.
Linked health, pharmaceutical use, and income data from British Columbia were analyzed to examine antipsychotic use in 2 study cohorts. In the first cohort, the essential use of antipsychotics was assessed among adults who had a recorded diagnosis of schizophrenia in a 2-year period, 2004-2005. In the second cohort, potentially inappropriate use of antipsychotics was examined in people with no recorded diagnosis of schizophrenia or bipolar disorders in 2004-2005. The second cohort was also composed exclusively of seniors with a dementia-related diagnosis who are either in long-term care or living in the community. Income-related differences in antipsychotic use in these 2 cohorts were assessed using logistic regression, controlling for health and sociodemographic characteristics known to influence medicine use.
Among adults, the prevalence of essential antipsychotic use was high (85%), with higher odds of use evident among those in the middle-income group. Among seniors, the prevalence of potentially inappropriate antipsychotic treatment is 23%, with prevalence higher in long-term care (56%) than in the community (13%). No income-related differences were found in long-term care; however, in the community, higher odds of use were found in low-income seniors.
People from low-income households have slightly lower levels of essential antipsychotic use and are more likely to receive potentially inappropriate antipsychotic treatment.
研究不同收入群体抗精神病药物的基本和潜在不合理使用情况。
分析不列颠哥伦比亚省的健康、药物使用和收入相关数据，以研究两个研究队列中的抗精神病药物使用情况。在第一个队列中，评估了在 2004-2005 年期间有记录的精神分裂症诊断的成年人中抗精神病药物的基本使用情况。在第二个队列中，研究了在 2004-2005 年期间没有记录的精神分裂症或双相情感障碍诊断的人群中抗精神病药物的潜在不合理使用情况。第二个队列也完全由与痴呆症相关诊断的老年人组成，他们要么在长期护理中，要么生活在社区中。使用逻辑回归评估这两个队列中与收入相关的抗精神病药物使用差异，同时控制已知影响药物使用的健康和社会人口特征。
在成年人中，基本抗精神病药物使用的患病率很高（85%），中等收入组的使用几率更高。在老年人中，潜在不合理抗精神病药物治疗的患病率为 23%，长期护理中的患病率更高（56%），而在社区中的患病率较低（13%）。在长期护理中未发现与收入相关的差异；然而，在社区中，低收入老年人的使用几率更高。
来自低收入家庭的人使用基本抗精神病药物的水平略低，更有可能接受潜在不合理的抗精神病药物治疗。
