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通过长效抗精神病药物改善精神分裂症谱系障碍的“现实生活”管理:社区精神卫生服务中为期一年的镜像回顾性研究。

Improving the "real life" management of schizophrenia spectrum disorders by LAI antipsychotics: A one-year mirror-image retrospective study in community mental health services.

机构信息

Department of Mental Health, Azienda Sanitaria Locale Bari, Bari, Italy.

Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.

出版信息

PLoS One. 2020 Mar 10;15(3):e0230051. doi: 10.1371/journal.pone.0230051. eCollection 2020.

Abstract

Schizophrenia poses a significant economic burden on the healthcare system as well as it has a significant impact on society at large. Reasons for such a high economic burden of schizophrenia include the frequent relapses and hospitalizations occurring in this disorder. We analyze the effectiveness of long-acting injectable antipsychotics (LAIs) compared to oral medications, in terms of "clinical process management" in a sample of patients with a diagnosis of schizophrenia spectrum disorder treated in community mental health centers. An observational, retrospective, mirror-image study was carried out to evaluate the effectiveness of LAIs compared to oral medications in terms of number of hospitalizations, emergency visits and planned visits on a 10-year period (from July 2007 to June 2017). Differences between first and second generation LAIs were also explored. Our findings show that hospitalization and emergency visits are significantly decreased with the use of LAIs, while planned visits are increased in patients treated with LAIs. Our results suggest that LAIs, in particular, second generation ones, reduce hospitalization rates and emergency visits, improving the economic burden of schizophrenia. Therefore, LAIs should be considered a cost-effective treatment in the management of schizophrenia under routine conditions.

摘要

精神分裂症给医疗保健系统带来了巨大的经济负担,也对整个社会产生了重大影响。导致精神分裂症经济负担如此高的原因包括这种疾病频繁的复发和住院。我们分析了长效注射型抗精神病药物(LAls)与口服药物相比,在社区心理健康中心治疗的精神分裂症谱系障碍患者样本中,在“临床流程管理”方面的效果。我们进行了一项观察性、回顾性、镜像研究,以评估长效注射型抗精神病药物与口服药物在 10 年期间(2007 年 7 月至 2017 年 6 月)的住院次数、急诊就诊次数和计划就诊次数方面的效果。我们还探讨了第一代和第二代长效注射型抗精神病药物之间的差异。我们的研究结果表明,使用长效注射型抗精神病药物后,住院和急诊就诊次数显著减少,而接受长效注射型抗精神病药物治疗的患者的计划就诊次数增加。我们的结果表明,长效注射型抗精神病药物,特别是第二代,可降低住院率和急诊就诊率,从而改善精神分裂症的经济负担。因此,长效注射型抗精神病药物应被视为常规情况下管理精神分裂症的一种具有成本效益的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e06/7064243/f6017f88f0a5/pone.0230051.g001.jpg

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