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基于韩国真实世界证据的接受治疗的抽动障碍儿科患者的人群流行病学研究

Population-Based Epidemiology of Pediatric Patients with Treated Tic Disorders from Real-World Evidence in Korea.

作者信息

Choi Seungjin, Lee Hankil, Song Dong-Ho, Cheon Keun-Ah

机构信息

Department of Child and Adolescent Psychiatry, Severance Children's Hospital, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Republic of Korea.

出版信息

J Child Adolesc Psychopharmacol. 2019 Dec;29(10):764-772. doi: 10.1089/cap.2019.0050. Epub 2019 Jul 30.

Abstract

Although tic disorder (TD) is a common mental disorder in children and adolescents, epidemiological data based on real-world evidence (RWE) are insufficient. Using RWE, this study sought to examine the prevalence of treated TD, use of medical utilization, and use of prescription drugs among patients with TD with respect to TD type and comorbid psychiatric illness. We performed a retrospective cross-sectional study. Using the Korean Health Insurance Review and Assessment Service Pediatric Patient Sample data from 2009 to 2016, we analyzed 20,599 patients with TD (Korean Standard Classification of Diseases-6/7 code: F95.x) aged 2-19 years. The annual average TD prevalence was 2.6/1000 population (95% confidence interval, 2.3-2.8/1000). Between 2009 and 2016, a slight increase in TD prevalence was observed from 1.9 to 2.9/1000 population. The TD prevalence rate in male patients was four times higher than that in female patients. Differences were observed in health care utilization and drug prescription types between patients with Tourette syndrome and chronic or transient TD. In addition, more than half of patients with TD had comorbid psychiatric disorders, and one-third of patients with TD had attention-deficit/hyperactivity disorder (ADHD). Patients with TD without comorbidities were frequently prescribed aripiprazole, while patients with TD and comorbid ADHD were frequently prescribed atomoxetine, methylphenidate, risperidone, and aripiprazole. This study described the epidemiological characteristics of TD based on recent RWE from Korea, and its findings can help establish future TD evidence-based clinical guidelines and related policies.

摘要

尽管抽动障碍(TD)是儿童和青少年中常见的精神障碍,但基于真实世界证据(RWE)的流行病学数据并不充分。本研究利用RWE,旨在探讨已接受治疗的TD的患病率、医疗利用情况以及TD患者中关于TD类型和共病精神疾病的处方药使用情况。我们进行了一项回顾性横断面研究。利用韩国健康保险审查和评估服务机构2009年至2016年的儿科患者样本数据,我们分析了20599例年龄在2至19岁的TD患者(韩国疾病标准分类代码:F95.x)。TD的年平均患病率为2.6/1000人口(95%置信区间,2.3 - 2.8/1000)。在2009年至2016年期间,观察到TD患病率从1.9/1000人口略有上升至2.9/1000人口。男性患者的TD患病率是女性患者的四倍。在患有妥瑞氏综合征的患者与慢性或短暂性TD患者之间,在医疗保健利用和药物处方类型方面存在差异。此外,超过一半的TD患者患有共病精神障碍,三分之一的TD患者患有注意力缺陷/多动障碍(ADHD)。无共病的TD患者经常被处方阿立哌唑,而患有TD且共病ADHD的患者经常被处方托莫西汀、哌甲酯、利培酮和阿立哌唑。本研究基于韩国近期的RWE描述了TD的流行病学特征,其研究结果有助于制定未来基于证据的TD临床指南和相关政策。

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