Martin Barry A, Delva Nicholas John, Graf Peter, Gosselin Caroline, Enns Murray W, Gilron Ian, Jewell Mark, Lawson James Stuart, Milev Roumen, Patry Simon, Chan Peter K Y
From the *Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; †Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Departments of ‡Psychology and §Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; ∥Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada; ¶Department of Anaesthesiology & Perioperative Medicine and Biomedical Molecular Sciences, Queen's University, Kingston, Ontario, Canada; #Addiction and Mental Health, Alberta Health Services, Edmonton, Alberta, Canada; **Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; and ††Laval University, Quebec City, Quebec, Canada.
J ECT. 2015 Jun;31(2):119-24. doi: 10.1097/YCT.0000000000000192.
The aims of this study were to document electroconvulsive therapy use in Canada with respect to treatment facilities and caseloads based on a survey of practice (Canadian Electroconvulsive Therapy Survey/Enquete Canadienne Sur Les Electrochocs-CANECTS/ECANEC) and to consider these findings in the context of guideline recommendations.
All 1273 registered hospitals in Canada were contacted, and 175 sites were identified as providing electroconvulsive therapy; these sites were invited to complete a comprehensive questionnaire. The survey period was calendar year 2006 or fiscal year 2006/2007. National usage rates were estimated from the responses.
Sixty-one percent of the sites completed the questionnaire; a further 10% provided caseload data. Seventy were identified as general; 31, as university teaching; and 21, as provincial psychiatric/other single specialty (psychiatric) hospitals. Caseload volumes ranged from a mean of fewer than 2 to greater than 30 treatments per week. Estimated national usage during the 1-year survey period was 7340 to 8083 patients (2.32-2.56 per 10,000 population) and 66,791 to 67,424 treatments (2.11-2.13 per 1000 population). The diagnostic indications, admission status, and protocols for course end points are described.
The usage rates are in keeping with earlier Canadian data and with those from other jurisdictions. The difficulty obtaining caseload data from individual hospitals is indicative of the need for standardized data collection to support both clinical research and quality assurance. The wide variation in protocols for number of treatments per course indicates a need for better informed clinical guidelines. The broad range of caseload volumes suggests the need to review the economies of scale in the field.
本研究旨在通过一项实践调查（加拿大电休克治疗调查/加拿大电休克调查-CANECTS/ECANEC）记录加拿大电休克治疗在治疗设施和病例数量方面的使用情况，并结合指南建议来考量这些结果。
联系了加拿大所有1273家注册医院，确定了175个提供电休克治疗的地点；邀请这些地点填写一份综合问卷。调查期为2006日历年或2006/2007财政年度。根据回复估算全国使用率。
61%的地点完成了问卷；另有10%提供了病例数量数据。确定70家为综合医院；31家为大学教学医院；21家为省级精神病院/其他单一专科（精神病）医院。每周病例数量从平均少于2例到多于30例不等。在为期1年的调查期内，全国估计使用量为7340至8083名患者（每10000人口2.32 - 2.56例）和66791至67424次治疗（每1000人口2.11 - 2.13例）。描述了诊断指征、入院状态和疗程终点方案。
使用率与加拿大早期数据以及其他司法管辖区的数据一致。从各医院获取病例数量数据存在困难，这表明需要进行标准化数据收集以支持临床研究和质量保证。每个疗程治疗次数方案的广泛差异表明需要更完善的临床指南。病例数量的广泛范围表明需要审查该领域的规模经济。
