种族-民族差异在精神分裂症患者接受 FDA 咨询后奥氮平使用的发生率上的表现。
Racial-ethnic differences in incident olanzapine use after an FDA advisory for patients with schizophrenia.
机构信息
Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
出版信息
Psychiatr Serv. 2013 Jan;64(1):83-7. doi: 10.1176/appi.ps.201200002.
OBJECTIVE
Prior investigations suggest that olanzapine use declined rapidly after a U.S. Food and Drug Administration (FDA) communication and consensus statement warning of the drug's increased metabolic risks, but whether declines differed by racial-ethnic groups is unknown.
METHODS
Changes in olanzapine use over time by race-ethnicity was assessed among 7,901 Florida Medicaid enrollees with schizophrenia.
RESULTS
Prior to the advisory, 57% of second-generation antipsychotic fills among Hispanics were for olanzapine, compared with 40% for whites or blacks (adjusted risk difference [ARD]=.17, 95% confidence interval [CI]=.13-.20). Olanzapine use declined among all racial-ethnic groups. Although Hispanics had greater olanzapine use than whites in each period, the differences in absolute risk were only 3% by the latest study period (ARD=.03, CI=.01-.04).
CONCLUSIONS
After the FDA communication and consensus statement were issued, differences in olanzapine use between white and Hispanic enrollees narrowed considerably. Identifying high-use subgroups for targeted delivery of drug safety information may help eliminate any existing differences in prescribing.
目的
先前的调查表明，在美国食品和药物管理局（FDA）发布关于药物代谢风险增加的沟通和共识声明后，奥氮平的使用迅速下降，但尚不清楚下降是否因种族/族裔群体而异。
方法
在佛罗里达州医疗补助计划的 7901 名精神分裂症患者中，评估了种族/族裔随时间变化的奥氮平使用情况。
结果
在咨询之前，西班牙裔第二代抗精神病药物中有 57%是奥氮平，而白人和黑人的这一比例为 40%（调整后的风险差异[ARD]=.17，95%置信区间[CI]=.13-.20）。所有种族/族裔群体的奥氮平使用均有所下降。尽管在每个时期，西班牙裔的奥氮平使用量都高于白人，但在最近的研究期间，绝对风险差异仅为 3%（ARD=.03，CI=.01-.04）。
结论
在 FDA 发布沟通和共识声明后，白人和西班牙裔参保者之间奥氮平使用的差异大大缩小。确定高用量亚组，以便有针对性地提供药物安全信息，可能有助于消除处方方面现有的差异。
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