Li Mingming, Cai Jian, Zhang Ping, Fei Chunhua, Xu Feng
Department of Clinical Pharmacy, Fengxian Hospital, Southern Medical University Shanghai, China.
Department of Mood Disorder, Fengxian Mental Health Center Shanghai, China.
Front Pharmacol. 2017 Jan 10;7:540. doi: 10.3389/fphar.2016.00540. eCollection 2016.
Patient's response to drug brand is a comprehensive physiological and psychological effect which might impact the compliance and efficacy of drugs. Whether the therapeutic outcome altered on patients with brand response after they experience drug switch is not clear. 459 outpatients with mild-to-moderate depression were divided into the imported (joint venture) drug group and the domestic drug group according to their current drug application. Two groups of patients were assessed by drug brand preference questionnaire and medication compliance questionnaire. Patients with brand preference in imported (joint venture) drugs group received rational use of limited medical resource and pharmacoeconomics education, and then switched with domestic drug for 8 weeks. Safety and efficacy were evaluated both before and after the drug switch. Overall, there were 27% of patients in imported drug group and 35% of patients in domestic drug group have brand response, respectively. About 2/3 patients in both groups showed low or no brand response. The compliance was similar in both groups with no significant difference (6.04 ± 2.08 vs. 4.74 ± 2.13, respectively, > 0.05). The efficacy of imported drug group was significantly better than of the domestic drug group. Correlation analysis showed that in imported (joint venture) drugs group, medication compliance was closely related with brand response, but negatively correlated with age and duration. In domestic drugs group, medication compliance was independent of brand response, but closely related with education, age, and duration. After drug switch with domestic drug on patients with brand response, patients continued to maintain good antidepressant effect, and no severe adverse reaction occurred. The results suggested that domestic drugs switch might be feasible for patients using imported drugs with brand response, while providing patients with rational use of drug education and psychological support. The medical staff should focus on medication education to help patients make better use of limited medical resources.
患者对药品品牌的反应是一种综合的生理和心理效应，可能会影响药物的依从性和疗效。在经历药物转换后，有品牌反应的患者其治疗结果是否改变尚不清楚。459例轻至中度抑郁症门诊患者根据其当前用药情况分为进口（合资）药品组和国产药品组。两组患者均通过药品品牌偏好问卷和用药依从性问卷进行评估。进口（合资）药品组中有品牌偏好的患者接受合理使用有限医疗资源和药物经济学教育，然后换用国产药品8周。在药物转换前后均评估安全性和疗效。总体而言，进口药品组有27%的患者、国产药品组有35%的患者有品牌反应。两组中约2/3的患者表现出低品牌反应或无品牌反应。两组的依从性相似，无显著差异（分别为6.04±2.08和4.74±2.13，P>0.05）。进口药品组的疗效明显优于国产药品组。相关性分析表明，在进口（合资）药品组中，用药依从性与品牌反应密切相关，但与年龄和病程呈负相关。在国产药品组中，用药依从性与品牌反应无关，但与教育程度、年龄和病程密切相关。对有品牌反应的患者换用国产药品后，患者继续维持良好的抗抑郁效果，未发生严重不良反应。结果提示，对于有品牌反应的使用进口药品的患者，换用国产药品可能可行，同时为患者提供合理用药教育和心理支持。医务人员应注重用药教育，帮助患者更好地利用有限的医疗资源。
