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成人 ADHD 中兴奋剂治疗依从性低的进一步证据:一项电子病历研究,考察了兴奋剂处方的及时续方。

Further evidence of low adherence to stimulant treatment in adult ADHD: an electronic medical record study examining timely renewal of a stimulant prescription.

机构信息

Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, YAW 6900, Boston, MA, 02114, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

Psychopharmacology (Berl). 2020 Sep;237(9):2835-2843. doi: 10.1007/s00213-020-05576-y. Epub 2020 Jun 26.

Abstract

RATIONALE

ADHD is a prevalent and morbid neurobiological disorder affecting up to 5% of adults. While stimulants have been documented to be safe and effective in adults with ADHD, uncertainties remain about adherence to these treatments.

OBJECTIVES

The main aim of this article was to evaluate contemporaneous rates and correlates of adherence to stimulants in adults with ADHD using data from electronic medical records from a large healthcare organization focusing on timely renewal of an initial prescription.

METHODS

Subjects were patients 18 to 44 years of age who had been prescribed a stimulant between January 1, 2015, and December 31, 2016. Prescription and sociodemographic data were extracted from the Partners HealthCare Research Patient Data Registry (RPDR). Our outcome metric was renewal of the index stimulant prescription defined as the first prescription recorded in the electronic record for the period under investigation.

RESULTS

We identified 2689 patients with an index prescription for a stimulant medication. Results showed that only 42% of patients renewed their prescriptions in a timely enough fashion to be considered consistently medicated.

CONCLUSIONS

Results indicate that adults with ADHD have a low rate of renewal of their initial stimulant prescription indicating poor patient engagement in their treatment for ADHD.

摘要

背景

注意力缺陷多动障碍(ADHD)是一种常见的、病态的神经生物学障碍,影响着多达 5%的成年人。虽然兴奋剂已被证明对 ADHD 成人是安全有效的,但对这些治疗的依从性仍存在不确定性。

目的

本文的主要目的是使用来自一家专注于及时更新初始处方的大型医疗机构的电子病历数据,评估 ADHD 成年患者对兴奋剂的依从率及其相关因素。

方法

研究对象为 2015 年 1 月 1 日至 2016 年 12 月 31 日期间被开具兴奋剂处方的 18 至 44 岁患者。处方和社会人口统计学数据从合作伙伴医疗保健研究患者数据登记处(RPDR)中提取。我们的主要结局指标是指数兴奋剂处方的更新,定义为调查期间电子记录中首次记录的处方。

结果

我们确定了 2689 例索引处方开具兴奋剂药物的患者。结果表明,只有 42%的患者及时更新了处方,从而被认为持续接受药物治疗。

结论

结果表明,ADHD 成年患者初始兴奋剂处方的更新率较低,表明患者对 ADHD 治疗的参与度较差。

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