Szkultecka-Dębek Monika, Miernik Katarzyna, Stelmachowski Jarosław, Jakovljević Miro, Jukić Vlado, Aadamsoo Kaire, Janno Sven, Bitter István, Tolna Judit, Jarema Marek, Jankovic Slobodan, Pecenak Jan, Vavrusova Livia, Tavčar Rok, Walczak Jacek, Talbot Darren, Augustyńska Joanna
Roche Polska Sp. z o.o., ul. Domaniewska 39 B, 02-672 Warszawa, Poland,
Psychiatr Danub. 2016 Sep;28(3):234-242.
The aim is to analyze how schizophrenia is pharmacologically treated in seven CEE countries: Croatia, Estonia, Hungary, Poland, Serbia, Slovakia and Slovenia.
Psychiatrists from selected centers in each of participating countries were asked to complete a pre-defined questionnaire on their current clinical practice. Information on protocols and resource utilization in schizophrenia treatment was included and derived from randomly selected patient medical records. Expert opinions on country-wide treatment patterns were additionally sought. This sub-analysis focuses on pharmacological treatment patterns in the last six months and over the course of the disease.
961 patients' data show that during last six months the most commonly prescribed medications were oral atypical antipsychotics: olanzapine (n=268), clozapine (n=234) and risperidone (n=160). The most frequently prescribed atypical antipsychotics over course of disease were: risperidone (54.5%), olanzapine (52.4%) and clozapine (35.1%), along with haloperidol (39.3%). Experts reported risperidone (four countries) and olanzapine (three countries) as first-line treatment, with the same two medications prescribed as second-line treatment. Clozapine was the most reported medication for refractory patients. Approximately 22% of patients received polypharmacy with antipsychotics in at least one period over the disease course. Mean time since diagnosis was 13.1 years and on average 4.8 treatment courses received during that period. Anxiolytics (70%), antidepressants (42%), mood-stabilizers (27%) were also prescribed, with diazepam (35.4%), sertraline (10.5%), valproic acid (17.5%) the most commonly reported, respectively, in each group. The most frequently reported treatment change was switch from one oral atypical antipsychotic to another (51%).
Oral atypical antipsychotics, mostly older drugs (risperidone, olanzapine, clozapine), were most commonly prescribed for schizophrenia treatment in participating countries. Given that results are from the first large-scale analysis of RWD, we believe these findings can be a benchmark for future real-world studies, which could contribute to the optimization of treatment for this debilitating disease.
分析在七个中东欧国家(克罗地亚、爱沙尼亚、匈牙利、波兰、塞尔维亚、斯洛伐克和斯洛文尼亚)精神分裂症的药物治疗情况。
要求每个参与国选定中心的精神科医生填写一份关于其当前临床实践的预定义问卷。问卷包含精神分裂症治疗方案和资源利用的信息,这些信息来自随机抽取的患者病历。此外,还征求了关于全国治疗模式的专家意见。本亚组分析聚焦于过去六个月以及疾病过程中的药物治疗模式。
961名患者的数据显示,在过去六个月中,最常处方的药物是口服非典型抗精神病药物:奥氮平(n = 268)、氯氮平(n = 234)和利培酮(n = 160)。在疾病过程中最常处方的非典型抗精神病药物是:利培酮(54.5%)、奥氮平(52.4%)和氯氮平(35.1%),以及氟哌啶醇(39.3%)。专家报告利培酮(四个国家)和奥氮平(三个国家)为一线治疗药物,这两种药物也被用作二线治疗。氯氮平是治疗难治性患者报告最多的药物。在疾病过程中的至少一个阶段,约22%的患者接受了抗精神病药物联合治疗。自诊断以来的平均时间为13.1年,在此期间平均接受了4.8个疗程的治疗。还开具了抗焦虑药(70%)、抗抑郁药(42%)、心境稳定剂(27%),每组中最常报告的分别是地西泮(35.4%)、舍曲林(10.5%)、丙戊酸(17.5%)。最常报告的治疗变化是从一种口服非典型抗精神病药物换用另一种(51%)。
口服非典型抗精神病药物,大多是较老的药物(利培酮、奥氮平、氯氮平),在参与国最常用于精神分裂症治疗。鉴于这些结果来自对真实世界数据的首次大规模分析,我们认为这些发现可为未来的真实世界研究提供基准,这可能有助于优化这种使人衰弱疾病的治疗。