Bhattacharjee Sandipan, Axon David Rhys, Goldstone Lisa, Lee Jeannie K
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona.
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, Arizona.
J Stroke Cerebrovasc Dis. 2018 Mar;27(3):563-567. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.047. Epub 2017 Oct 31.
Despite the importance of treating depression, little is known regarding the current practice pattern of depression treatment among older adults with stroke and depression. We used national survey data from ambulatory settings to examine the depression treatment patterns and predictors among stroke survivors in the United States (US).
We used a cross-sectional study design by pooling multiple-year data (2005-2011) from the National Ambulatory Medical Care Survey and the outpatient department of the National Hospital Ambulatory Medical Care Survey. Older adults (age ≥50 years) with stroke and depression constituted the final study sample. Depression treatment defined as antidepressant use with or without psychotherapy was the dependent variable in this study. All analyses adjusted for the complex survey design of the datasets to obtain nationally representative estimates.
The overall depression treatment was observed in 47.32% of the study sample, mainly driven by antidepressant use alone. An overwhelming majority used selective serotonin reuptake inhibitors (77% of overall antidepressant use), and sertraline was the most prescribed antidepressant (30.5% of overall antidepressant use). Gender, race or ethnicity, region of residence, number of medications recorded at the sampled visit, and number of chronic conditions were significantly associated with depression treatment.
According to this nationally representative sample, approximately 1 in 2 stroke survivors with depression received depression treatment in ambulatory care settings in the US. Appropriate interventions should be developed to optimize depression treatment.
尽管治疗抑郁症很重要，但对于患有中风和抑郁症的老年人目前的抑郁症治疗实践模式知之甚少。我们使用来自门诊机构的全国性调查数据来研究美国中风幸存者的抑郁症治疗模式及预测因素。
我们采用横断面研究设计，汇总了来自国家门诊医疗调查和国家医院门诊医疗调查门诊部的多年数据（2005 - 2011年）。患有中风和抑郁症的老年人（年龄≥50岁）构成了最终研究样本。本研究中，抑郁症治疗定义为使用或不使用心理治疗的抗抑郁药治疗，是因变量。所有分析都对数据集的复杂调查设计进行了调整，以获得具有全国代表性的估计值。
在47.32%的研究样本中观察到了总体抑郁症治疗情况，主要是由单独使用抗抑郁药推动的。绝大多数人使用选择性5-羟色胺再摄取抑制剂（占总体抗抑郁药使用量的77%），而舍曲林是处方最多的抗抑郁药（占总体抗抑郁药使用量的30.5%）。性别、种族或民族、居住地区、在抽样就诊时记录的用药数量以及慢性病数量与抑郁症治疗显著相关。
根据这个具有全国代表性的样本，在美国门诊护理环境中，约二分之一患有抑郁症的中风幸存者接受了抑郁症治疗。应制定适当的干预措施以优化抑郁症治疗。
