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初级保健中老年人群精神障碍的识别:一项横断面数据库研究。

Identified mental disorders in older adults in primary care: A cross-sectional database study.

机构信息

a UCD School of Medicine , University College Dublin , Dublin , Ireland.

b Institute of Psychiatry , King's College London , London , UK.

出版信息

Eur J Gen Pract. 2018 Dec;24(1):84-91. doi: 10.1080/13814788.2017.1402884.

Abstract

INTRODUCTION

Identifying and managing mental disorders among older adults is an important challenge for primary care in Europe. Electronic medical records (EMRs) offer considerable potential in this regard, although there is a paucity of data on their use for this purpose.

OBJECTIVES

To examine the prevalence/treatment of identified mental disorders among older adults (over 55 years) by using data derived from EMRs in general practice.

METHODS

We utilized data from a cross-sectional study of mental disorders in primary care, which identified patients with mental disorders based on diagnostic coding and prescribed medicines. We collected anonymized data from 35 practices nationally from June 2014 to March 2015, and secondary analysis of this dataset examined the prevalence of mental disorders in adults aged over 55 years.

RESULTS

74,261 patients aged over 55 years were identified, of whom 14,143 had a mental health disorder (prevalence rate of 19.1%). There was considerable variation between practices (range: 3.7-38.9%), with a median prevalence of 23.1%. Prevalence increased with age, from 14.8% at 55-59 years to 28.9% at 80-84 years. Most common disorders were depression (17.1%), panic/anxiety (11.3%), cognitive (5.6%), alcohol (3.8%) and substance use (3.8%).

CONCLUSIONS

Examining mental disorders among older adults using data derived from EMRs is feasible. Mental disorders are common among older adults attending primary care and this study demonstrates the utility of electronic medical records in epidemiological studies of large populations in primary care.

摘要

简介

在欧洲,识别和管理老年人的精神障碍是初级保健的一项重要挑战。电子病历(EMR)在这方面具有相当大的潜力,尽管关于将其用于此目的的数据很少。

目的

利用来自一般实践中的电子病历数据,检查老年(55 岁以上)人群中已识别精神障碍的患病率/治疗情况。

方法

我们利用了一项初级保健中精神障碍的横断面研究的数据,该研究根据诊断编码和开处方的药物确定了患有精神障碍的患者。我们从 2014 年 6 月至 2015 年 3 月在全国范围内从 35 家诊所收集了匿名数据,对该数据集的二次分析检查了 55 岁以上成年人精神障碍的患病率。

结果

确定了 74261 名 55 岁以上的患者,其中 14143 人患有心理健康障碍(患病率为 19.1%)。诊所之间存在很大差异(范围:3.7-38.9%),中位数患病率为 23.1%。患病率随年龄增长而增加,从 55-59 岁的 14.8%增加到 80-84 岁的 28.9%。最常见的疾病是抑郁症(17.1%)、恐慌/焦虑症(11.3%)、认知障碍(5.6%)、酒精(3.8%)和物质使用障碍(3.8%)。

结论

使用从 EMR 数据中提取的数据来检查老年人的精神障碍是可行的。老年人在初级保健中患有精神障碍很常见,本研究证明了电子病历在初级保健中对大型人群进行流行病学研究的实用性。

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