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药物治疗对广泛性焦虑症患者健康相关生活质量的影响。

The impact of medication on health-related quality of life in patients with generalized anxiety disorder.

作者信息

Wilson Hilary, Mannix Sally, Oko-osi Hafiz, Revicki Dennis A

机构信息

Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA,

出版信息

CNS Drugs. 2015 Jan;29(1):29-40. doi: 10.1007/s40263-014-0217-8.

Abstract

BACKGROUND AND OBJECTIVE

Generalized anxiety disorder (GAD) is a psychiatric disorder characterized by excess worry and anxiety. GAD impacts overall health-related quality of life (HRQL), level of functioning, and disability. This literature review was conducted to understand the impact of pharmacological treatments on HRQL and functional outcomes.

METHODS

A literature review was conducted to identify randomized controlled trials (RCTs) comparing GAD pharmacological treatments with one or more patient-reported outcome (PRO) measure assessing HRQL, disability, functioning, or work productivity. Four databases were searched (PubMed, EMBASE, Cochrane Reviews, PsycInfo). Limits included English-language publications from 2004-2014. Abstracts and articles were reviewed to select articles reporting results of RCTs of pharmacological treatments for GAD that included one or more PRO measure. Article abstraction and summarization focused on key elements of the study design and PRO results.

RESULTS

One hundred sixty-three abstracts were reviewed; 44 articles were requested; 12 articles, representing 19 studies, were deemed relevant. The Sheehan Disability Scale (SDS) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) were the most frequently utilized PRO measures. In clinical trials with significant anxiety symptom reductions, the SDS and Q-LES-Q also improved with treatment and differentiated from placebo. Two trials included a measure of work productivity; both demonstrated significant improvements with short-term treatment.

CONCLUSION

Treatments that reduce anxiety symptoms are also associated with improvements in patient-reported HRQL, function, and disability. In addition to evaluation of treatment impacts on anxiety symptoms, clinical trials should include PRO measures of HRQL, disability, and functioning.

摘要

背景与目的

广泛性焦虑障碍(GAD)是一种以过度担忧和焦虑为特征的精神障碍。GAD会影响与健康相关的总体生活质量(HRQL)、功能水平和残疾状况。进行本次文献综述是为了了解药物治疗对HRQL和功能结局的影响。

方法

进行文献综述以确定将GAD药物治疗与一项或多项评估HRQL、残疾、功能或工作效率的患者报告结局(PRO)指标进行比较的随机对照试验(RCT)。检索了四个数据库(PubMed、EMBASE、Cochrane系统评价、PsycInfo)。限定条件包括2004年至2014年的英文出版物。对摘要和文章进行了审查,以选择报告GAD药物治疗RCT结果且包括一项或多项PRO指标的文章。文章提取和总结聚焦于研究设计的关键要素和PRO结果。

结果

共审查了163篇摘要;索取了44篇文章;12篇文章(代表19项研究)被认为相关。Sheehan残疾量表(SDS)和生活质量享受与满意度问卷(Q-LES-Q)是最常用的PRO指标。在焦虑症状显著减轻的临床试验中,SDS和Q-LES-Q也随治疗得到改善且与安慰剂有差异。两项试验纳入了工作效率指标;两者均显示短期治疗有显著改善。

结论

减轻焦虑症状的治疗也与患者报告的HRQL、功能和残疾状况的改善相关。除了评估治疗对焦虑症状的影响外,临床试验还应包括HRQL、残疾和功能的PRO指标。

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