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基于证据的抗抑郁药治疗创伤后应激障碍的测量策略:趋势及与患者报告结局的关联。

Measurement Strategies for Evidence-Based Antidepressants for Posttraumatic Stress Disorder Delivery: Trends and Associations with Patient-Reported Outcomes.

机构信息

White River Junction VA Medical Center, 215 North Main Street, White River Junction, VT, 05009, USA.

Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

出版信息

Adm Policy Ment Health. 2021 Jan;48(1):70-87. doi: 10.1007/s10488-020-01047-w.

Abstract

We sought to develop a quality standard for the prescription of antidepressants for posttraumatic stress disorder (PTSD) that is both consistent with the underlying evidence supporting antidepressants as a treatment for PTSD and associated with the best levels of symptom improvement. We quantified antidepressant initiation during the first year of PTSD treatment in a 10-year national cohort of Department of Veterans Affairs (VA) users, and compared outcomes in a subgroup who completed patient-reported outcome measurement (PROM) as part of routine practice. We added progressively stringent measurement requirements. Prescribing quality for PTSD in the VA was stable over time. Use of PROM was rare in the case of antidepressant treatment, limiting our assessment of outcomes.

摘要

我们旨在制定一个抗抑郁药物治疗创伤后应激障碍(PTSD)的质量标准,该标准既符合支持抗抑郁药物治疗 PTSD 的基本证据,又与最佳症状改善水平相关。我们在退伍军人事务部(VA)患者的 10 年国家队列中量化了 PTSD 治疗第一年的抗抑郁药物起始治疗情况,并在完成患者报告的结果测量(PROM)的亚组中比较了结果,该亚组是常规实践的一部分。我们逐步增加了严格的测量要求。VA 中 PTSD 的处方质量随时间保持稳定。在抗抑郁药物治疗的情况下,很少使用 PROM,这限制了我们对结果的评估。

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