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基于一项全国性医疗保险索赔数据库,调查日本常见癌症患者中精神药物的流行程度和初始处方情况。

Prevalence and initial prescription of psychotropics in patients with common cancers in Japan, based on a nationwide health insurance claims database.

机构信息

Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.

Keihanshin Consortium for Fostering the Next Generation of Global Leaders in Research (K-CONNEX), Kyoto, Japan.

出版信息

Psychooncology. 2018 Feb;27(2):450-457. doi: 10.1002/pon.4511. Epub 2017 Aug 18.

Abstract

OBJECTIVE

To investigate the prevalence of psychotropic medication use and identify factors affecting the prescription of psychotropics among patients newly diagnosed with any of 8 common types of cancer.

METHODS

This retrospective descriptive study examined data for patients newly diagnosed with breast, colorectal, liver, lung, ovarian, pancreatic, prostate, or stomach cancer between July 2009 and May 2014. The data were derived from a nationwide health claims database. The proportion of initial prescriptions for all oral psychotropics within 13 months of cancer diagnosis was analyzed by cancer type; the odds ratio (OR) for prescribing psychotropics was calculated using multivariable logistic regression models.

RESULTS

A total of 14 661 patients were newly diagnosed with cancer. Psychotropics were prescribed for 6593 (45%) patients. The highest and lowest proportions of psychotropic prescriptions were recorded for patients with lung cancer (62.6%) and prostate cancer (35.1%), respectively. The strongest predictors for psychotropic prescriptions were chemotherapy (OR, 2.59; 95% confidence interval [CI], 2.31-2.91; P < .001), lung cancer (OR, 2.47; 95% CI, 2.16-2.83; P < .001), and surgery (OR, 2.12; 95% CI, 1.97-2.28; P < .001).

CONCLUSIONS

The prevalence of and predictors for an initial prescription of psychotropics identified a potential target population of cancer patients requiring psychiatric treatment, particularly soon after a diagnosis of cancer.

摘要

目的

调查新诊断出 8 种常见类型癌症患者使用精神药物的流行情况,并确定影响精神药物处方的因素。

方法

本回顾性描述性研究分析了 2009 年 7 月至 2014 年 5 月期间新诊断为乳腺癌、结直肠癌、肝癌、肺癌、卵巢癌、胰腺癌、前列腺癌或胃癌的患者的数据。数据来源于全国性健康索赔数据库。通过癌症类型分析了癌症诊断后 13 个月内所有口服精神药物初始处方的比例;使用多变量逻辑回归模型计算了开具精神药物的优势比(OR)。

结果

共纳入 14661 例新诊断为癌症的患者。为 6593 例(45%)患者开具了精神药物。肺癌患者(62.6%)和前列腺癌患者(35.1%)开具精神药物的比例最高和最低。开具精神药物的最强预测因子为化疗(OR,2.59;95%置信区间[CI],2.31-2.91;P<0.001)、肺癌(OR,2.47;95% CI,2.16-2.83;P<0.001)和手术(OR,2.12;95% CI,1.97-2.28;P<0.001)。

结论

精神药物初始处方的流行情况和预测因子确定了需要精神治疗的癌症患者的潜在目标人群,尤其是在癌症诊断后不久。

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