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[哥伦比亚社会保障卫生系统附属患者的抗精神病药物处方模式]

[Antipsychotic prescription patterns in patients affiliated to the Social Security Health System in Colombia].

作者信息

Machado-Alba Jorge E, Morales-Plaza Cristhian David

机构信息

Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, , Universidad Tecnológica de Pereira-Audifarma S.A.

出版信息

Biomedica. 2013 Jul-Sep;33(3):418-28. doi: 10.7705/biomedica.v33i3.1529.

Abstract

INTRODUCTION

Schizophrenia alters individual perception, thought, affection and behavior. Drug therapy can improve these manifestations.

OBJECTIVE

To determine prescription patterns of antipsychotic drugs in a group of patients affiliated to the Social Security Health System in Colombia.

MATERIALS AND METHODS

This was a descriptive study with a 6.2 million people database. We selected 3,075 patients medicated with antipsychotics, of both sexes, and all ages, with continuous treatment from March to June, 2012, and residing in 57 Colombian cities. We designed a database on drug consumption, obtained by the company that distributes the drugs to the patients.

RESULTS

A total of 3,075 patients were studied, with an age mean of 55.8 ± 21.5 years; 50.3% of the participants were women. Of all patients, 81.9% were receiving monotherapy and 18.1% two or more antipsychotics. Prescription order was 77.1% atypical and 31.9% conventional. The most frequently used drugs were: quetiapine (on 30.3% of the patients), clozapine (23.7%), levomepropamize (18.4%), and risperidone (14.9%). The most common combinations were: haloperidol + levomepromazine (n=67, 12.1%), clozapine + pipotiazine (n=54, 9.7%), clozapine + risperidone (n=45, 8.1%), and quetiapine + levomepromazine (n=40, 7.2%). The most prescribed co-medications were: antidepressants (n=998, 32.5%), anxiolytic (n=799, 26.0%), statins (n=672, 21.9%); antiparkinsonians (n=341, 11.1%), and antidiabetic drugs (n=327, 10.6%).

CONCLUSIONS

The practice of prescribing drugs with a high therapeutic value predominates mainly in antipsychotic monotherapy. Most agents were used in higher doses than recommended. This raises the need to design educational strategies to address these prescribing habits and research for evaluating the effectiveness of the treatment.

摘要

引言

精神分裂症会改变个体的感知、思维、情感和行为。药物治疗可以改善这些症状。

目的

确定哥伦比亚社会保障卫生系统附属的一组患者中抗精神病药物的处方模式。

材料与方法

这是一项基于620万人数据库的描述性研究。我们选取了3075名接受抗精神病药物治疗的患者,涵盖所有性别和年龄段,在2012年3月至6月期间接受持续治疗,且居住在哥伦比亚的57个城市。我们设计了一个关于药物消费的数据库,由向患者分发药物的公司提供。

结果

共研究了3075名患者,平均年龄为55.8±21.5岁;50.3%的参与者为女性。在所有患者中,81.9%接受单一疗法,18.1%接受两种或更多种抗精神病药物治疗。处方顺序为非典型药物占77.1%,传统药物占31.9%。最常用的药物为:喹硫平(30.3%的患者使用)、氯氮平(23.7%)、左美丙嗪(18.4%)和利培酮(14.9%)。最常见的联合用药为:氟哌啶醇+左美丙嗪(n = 67,12.1%)、氯氮平+哌泊噻嗪(n = 54,9.7%)、氯氮平+利培酮(n = 45,8.1%)以及喹硫平+左美丙嗪(n = 40,7.2%)。最常开具的辅助药物为:抗抑郁药(n = 998,32.5%)、抗焦虑药(n = 799,26.0%)、他汀类药物(n = 672,21.9%)、抗帕金森病药物(n = 341,11.1%)以及抗糖尿病药物(n = 327,10.6%)。

结论

在抗精神病单一疗法中,主要以开具具有高治疗价值的药物为主。大多数药物的使用剂量高于推荐剂量。这就需要设计教育策略来应对这些处方习惯,并开展研究以评估治疗效果。

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