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抗胆碱能药物在使用精神药物的三项全国性调查(2002-2012 年)中的 14013 例精神分裂症患者中的使用趋势。

Anticholinergic use trends in 14,013 patients with schizophrenia from three national surveys on the use of psychotropic medications in China (2002-2012).

机构信息

Peking University Sixth Hospital (Institute of Mental Health) & National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.

Peking University Sixth Hospital (Institute of Mental Health) & National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China; Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China.

出版信息

Psychiatry Res. 2017 Nov;257:132-136. doi: 10.1016/j.psychres.2017.07.038. Epub 2017 Jul 21.

Abstract

Our previous study demonstrated that there have been changes in the patterns of prescription antipsychotic use in China over the period from 2002 to 2012. The aim of this study was to evaluate whether time trends were present for the prescription of anticholinergic medications (ACMs) during the observation period. A total of 14,013 patients with schizophrenia treated in 45 psychiatric hospitals/centers nationwide were surveyed in 2002, 2006 and 2012. Basic socio-demographic and clinical characteristics and the prescription of psychotropic drugs were recorded using a standardized protocol and data collection procedure. The frequency of ACM prescription was 25.9% in the whole sample (29.5%, 21.6%, and 27.4% in 2002, 2006 and 2012, respectively). In addition, different temporal trends were observed across age groups. Multiple logistic regression analysis of the entire sample showed that ACM prescriptions were predicted by females, outpatients, patients receiving high doses of antipsychotic medication, select study years, benzodiazepine users, patients displaying extrapyramidal side effects, as well as antipsychotic prescription patterns. Although there was more widespread use of second-generation antipsychotics over the past decade, the frequency of ACM use only slightly decreased. How to use ACM appropriately is still a therapeutic issue that needs to foster evidence-based prescription practice.

摘要

我们之前的研究表明,2002 年至 2012 年期间,中国处方抗精神病药物的使用模式发生了变化。本研究旨在评估在观察期间,抗胆碱能药物(ACMs)的处方是否存在时间趋势。我们对全国 45 家精神病医院/中心的 14013 名精神分裂症患者进行了调查,这些患者分别于 2002 年、2006 年和 2012 年接受治疗。使用标准化协议和数据收集程序记录了基本的社会人口学和临床特征以及精神药物的处方情况。ACM 处方的频率在全样本中为 25.9%(2002 年、2006 年和 2012 年分别为 29.5%、21.6%和 27.4%)。此外,不同的时间趋势在不同年龄组中观察到。对全样本进行的多因素逻辑回归分析表明,女性、门诊患者、接受高剂量抗精神病药物治疗的患者、特定研究年份、苯二氮䓬类药物使用者、出现锥体外系副作用的患者以及抗精神病药物处方模式是 ACM 处方的预测因素。尽管在过去十年中第二代抗精神病药物的使用更为广泛,但 ACM 的使用频率仅略有下降。如何适当使用 ACM 仍然是一个需要促进基于证据的处方实践的治疗问题。

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