The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark.
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus, Denmark.
Gen Hosp Psychiatry. 2018 Mar-Apr;51:96-105. doi: 10.1016/j.genhosppsych.2018.02.001. Epub 2018 Feb 2.
To describe the use of prescription drugs and their association with patient characteristics in patients with multiple functional somatic syndromes (FSS) focusing on drugs generally recommended and not recommended in FSS treatment.
Using data from a national prescription registry, we describe the drug use during a two-year period for 239 trial participants. Using regression models, we analyse the associations of patient characteristics with the patterns of use of antidepressants, anticonvulsants, opioids and sedatives.
The use of prescription drugs was highly heterogeneous. Antidepressants were used at least temporarily by 34% (88/239), anticonvulsants by 7% (16/239), opioids by 26% (61/239) and sedatives by 20% (47/239) of the patients. Severe impairment due to multiple FSS was associated with use of opioids or sedatives (OR 6.49 (95% CI 2.68-15.68; p < 0.001)) but also with use of antidepressants or anticonvulsants (OR 3.42 (95% CI 1.35-8.65; p = 0.009)). Poor self-reported physical health, additional physical comorbidities and low socioeconomic status were associated with use of opioids or sedatives only.
Antidepressants and anticonvulsants were modestly used. Opioids and sedatives were especially used by the severely affected patients. Balancing treatment expectations and enhancing patients' understanding of FSS may direct treatments towards more generally recommended drugs.
描述患有多种功能性躯体综合征(FSS)患者的处方药使用情况及其与患者特征的关系,重点关注 FSS 治疗中一般推荐和不推荐使用的药物。
利用国家处方登记处的数据,我们描述了 239 名试验参与者在两年期间的药物使用情况。使用回归模型,我们分析了患者特征与抗抑郁药、抗惊厥药、阿片类药物和镇静剂使用模式之间的关联。
处方药的使用具有高度异质性。抗抑郁药至少在 34%(88/239)的患者中被临时使用,抗惊厥药在 7%(16/239)的患者中被使用,阿片类药物在 26%(61/239)的患者中被使用,镇静剂在 20%(47/239)的患者中被使用。由于多种 FSS 导致的严重受损与阿片类药物或镇静剂的使用相关(OR 6.49(95%CI 2.68-15.68;p<0.001)),但也与抗抑郁药或抗惊厥药的使用相关(OR 3.42(95%CI 1.35-8.65;p=0.009))。自我报告的身体状况较差、额外的身体合并症和低社会经济地位仅与阿片类药物或镇静剂的使用相关。
抗抑郁药和抗惊厥药的使用适度。阿片类药物和镇静剂尤其被严重受影响的患者使用。平衡治疗期望并增强患者对 FSS 的理解,可能会使治疗方向转向更普遍推荐的药物。