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二类糖尿病患者的精神药物处方:来自爱尔兰的多实践研究。

Prescription of psychotropic medication in patients with type two diabetes mellitus: A multi-practice study from Ireland.

机构信息

a Department of General Practice, Graduate Entry Medical School, University of Limerick , Limerick , Ireland.

b Biostatistics at Graduate Entry Medical School, University of Limerick , Limerick , Ireland.

出版信息

Eur J Gen Pract. 2019 Jul;25(3):157-163. doi: 10.1080/13814788.2019.1640208. Epub 2019 Jul 23.

Abstract

Comorbid anxiety and depression and type two diabetes mellitus (T2DM) are commonly managed by General Practitioners (GPs). : To investigate the proportion of people with T2DM who are prescribed either antidepressant or benzodiazepine medications in general practice; to compare people with T2DM that have a prescription with those that do not in terms of patient characteristics, glycaemic control and healthcare utilization. : Anonymized data was collected by GPs and senior medical students from electronic medical records of patients with T2DM in 34 Irish general practices affiliated with the University of Limerick Graduate Entry Medical School during the 2013/14 academic year. Data included demographics, healthcare utilization, prescriptions and most recent glycosylated haemoglobin (HbA1c) measurement. : The sample included 2696 patients with T2DM, of which 733 (36.7%) were female, and with a median age of 66 years. The percentage with a current prescription for an antidepressant or benzodiazepine was 22% (95%CI: 18.9-24.9). Those with a current prescription for either drug were more likely to have attended the emergency department (28.3% vs 15.7%,  <0.001), to have been admitted to hospital (35.4% vs 21.3%,  <0.001) in the past year and attend their GP more frequently (median of 9 vs 7,  <0.001) than those without a prescription. Rates of poor glycaemic control were similar in those with and without a current prescription. : Over one-fifth of people with T2DM in Irish general practice are prescribed an antidepressant or benzodiazepine medication. Prescription of these is associated with increased healthcare utilization but not poorer glycaemic control.

摘要

患有共病焦虑和抑郁与 2 型糖尿病(T2DM)的患者通常由全科医生(GP)进行管理。本研究旨在调查在全科医疗实践中开具抗抑郁药或苯二氮䓬类药物处方的 T2DM 患者比例,并比较有处方和无处方的 T2DM 患者在患者特征、血糖控制和医疗保健利用方面的差异。

匿名数据由隶属于利默里克大学研究生入学医学院的 34 家爱尔兰全科诊所的全科医生和高级医学生,通过电子病历收集,收集时间为 2013/14 学年。数据包括人口统计学、医疗保健利用、处方和最近的糖化血红蛋白(HbA1c)测量值。

样本包括 2696 名 T2DM 患者,其中 733 名(36.7%)为女性,中位年龄为 66 岁。目前开具抗抑郁药或苯二氮䓬类药物处方的患者比例为 22%(95%CI:18.9-24.9)。与未开具此类药物处方的患者相比,有处方的患者更有可能就诊急诊(28.3%比 15.7%, <0.001)、过去一年住院(35.4%比 21.3%, <0.001)和更频繁地就诊全科医生(中位数 9 次比 7 次, <0.001)。有和无当前处方的患者血糖控制不佳的比例相似。

在爱尔兰的全科医疗实践中,超过五分之一的 T2DM 患者被开具抗抑郁药或苯二氮䓬类药物处方。这些药物的开具与更高的医疗保健利用相关,但与更差的血糖控制无关。

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