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长效注射用抗精神病药物起始治疗后的住院及急诊就诊情况。

Hospitalizations and emergency room visits after initiation of long-acting injectable antipsychotics.

作者信息

Heesch Chelsie B, Moore Troy A, Gutierrez Cynthia A, Lee Shuko

机构信息

Clinical Pharmacy Specialist, Psychiatry, Pharmacy Service, Southern Arizona VA Health Care System, Tucson, Arizona,

Clinical Pharmacy Specialist, Psychiatry, Pharmacy Service, South Texas Veterans Health Care System, San Antonio, Texas; Adjunct Assistant Professor, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin, Austin, Texas; Assistant Professor, Division of Community Recovery, Research, and Training, Department of Psychiatry, The University of Texas Health Science Center, San Antonio, Texas.

出版信息

Ment Health Clin. 2016 May 6;6(3):134-141. doi: 10.9740/mhc.2016.05.134. eCollection 2016 Jun.

Abstract

INTRODUCTION

Long-acting injectable antipsychotics (LAIs) serve as a means to ensure medication adherence with the intention of improving outcomes for psychiatric patients. Evidence remains inconclusive regarding the impact of LAIs on relapses and psychiatric hospitalizations rates.

METHODS

The primary objective of this retrospective pre/post study was to determine whether initiating an LAI in a veteran population with schizophrenia, schizoaffective disorder, or bipolar disorder is associated with a decrease in the 1-year rate of psychiatric hospitalizations and emergency room (ER) visits.

RESULTS

For the combined primary endpoint, the 1-year rate of psychiatric hospitalizations and ER visits for patients with schizophrenia, schizoaffective disorder, or bipolar disorder was not significantly reduced after initiation of LAIs (n = 50, median [interquartile range]: 1.5 [1, 3] to 1 [0, 3], = .055). However, the secondary endpoint of the 1-year rate of psychiatric hospitalizations was reduced (1 [0, 3] to 0 [0, 2], = .026). Additionally, for those who received injections on a regular basis, the 1-year rate of hospitalizations and ER visits was significantly reduced (2 [1, 3] to 0 [0, 1.5], = .009).

DISCUSSION

This retrospective study suggests that the initiation of LAIs is associated with a reduced rate of psychiatric hospitalizations as well as a reduced rate of psychiatric hospitalizations and ER visits for those patients who receive injections on a regular basis.

摘要

引言

长效注射用抗精神病药物(LAIs)是确保患者坚持服药的一种手段,旨在改善精神科患者的治疗效果。关于LAIs对复发率和精神病住院率的影响,证据仍不确凿。

方法

这项回顾性前后对照研究的主要目的是确定在患有精神分裂症、分裂情感性障碍或双相情感障碍的退伍军人中启动LAIs治疗是否与1年精神病住院率和急诊室(ER)就诊率的降低相关。

结果

对于综合主要终点,在启动LAIs治疗后,精神分裂症、分裂情感性障碍或双相情感障碍患者的1年精神病住院率和急诊室就诊率没有显著降低(n = 50,中位数[四分位间距]:从1.5[1, 3]降至1[0, 3],P = 0.055)。然而,1年精神病住院率这一次要终点有所降低(从1[0, 3]降至0[0, 2],P = 0.026)。此外,对于那些定期接受注射的患者,1年住院率和急诊室就诊率显著降低(从2[1, 3]降至0[0, 1.5],P = 0.009)。

讨论

这项回顾性研究表明,启动LAIs治疗与精神病住院率降低相关,对于那些定期接受注射的患者,还与精神病住院率和急诊室就诊率降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca4b/6007648/24a59e1e8226/i2168-9709-6-3-134-f01.jpg

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