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电子健康记录中记录的精神障碍与与大麻相关障碍之间的关联。

Associations between Psychiatric Disorders and Cannabis-Related Disorders Documented in Electronic Health Records.

机构信息

School of Social Sciences, Education and Social Work, Queens University , Belfast, ME, UK.

Department of Family Medicine, Oregon Health & Science University , Portland, OR, USA.

出版信息

J Psychoactive Drugs. 2020 Jul-Aug;52(3):228-236. doi: 10.1080/02791072.2020.1747665. Epub 2020 Apr 15.

Abstract

Data from a large network of community health centers connected via a single electronic health record (EHR) system examined associations between psychiatric disorders and documentation of a cannabis-related disorder among patients with reported cannabis use. Participants were adults who had at least one ambulatory visit at a clinic in three states between 1/1/2012 and 12/31/2016 and had either 1) a documented cannabis-related disorder indicated by an ICD-9/10 code on the problem list or encounter list or 2) documentation of cannabis use in the EHR social history section. Clinics included 101,405 patients with either cannabis use recorded in the social history of the EHR (n = 71,660) or a cannabis-related disorder documented in the encounter or problem list (n = 29,745). GEE logistic regression modeling estimated adjusted odds ratios (aOR). Odds of patients having cannabis-related disorder recorded on the encounter or problem list were higher for individuals with depression (aOR = 1.08, 95% CI: 1.04-1.13), anxiety (aOR = 1.16, CI: 1.11-1.21) and bipolar disorder (aOR = 1.16, CI: 1.10-1.23). A diagnosis of schizophrenia increased the odds of a cannabis-related disorder by 62% (aOR = 1.62, CI: 1.48- 1.78). Primary care providers should routinely screen for and document cannabis-related disorders and psychiatric disorders.

摘要

一项基于大型社区医疗中心网络的研究数据,这些中心通过单一的电子健康记录 (EHR) 系统连接,旨在研究精神障碍与患者报告的大麻使用相关障碍的文档记录之间的关联。参与者为成年人,他们在三个州的诊所至少有一次门诊就诊,时间在 2012 年 1 月 1 日至 2016 年 12 月 31 日之间,并且:1)在问题清单或就诊清单上有明确的大麻相关障碍的记录,通过 ICD-9/10 代码指示;或 2)在 EHR 社会史部分有大麻使用的记录。这些诊所共纳入了 101,405 名患者,其中 EHR 社会史中记录了大麻使用情况(n=71,660)或在就诊或问题清单上记录了大麻相关障碍(n=29,745)。广义估计方程逻辑回归模型估计了调整后的优势比(aOR)。在就诊或问题清单上记录大麻相关障碍的患者,患有抑郁症的个体(aOR=1.08,95%CI:1.04-1.13)、焦虑症(aOR=1.16,CI:1.11-1.21)和双相情感障碍(aOR=1.16,CI:1.10-1.23)的几率更高。精神分裂症的诊断使大麻相关障碍的几率增加了 62%(aOR=1.62,CI:1.48-1.78)。初级保健提供者应常规筛查大麻相关障碍和精神障碍,并记录相关信息。

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