Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Infectious Diseases, Kyoto City Hospital, Kyoto, Japan.
PLoS One. 2020 Oct 5;15(10):e0240236. doi: 10.1371/journal.pone.0240236. eCollection 2020.
To investigate the association of mental health and subjective physical functioning with future antibiotic prescriptions.
Prospective cohort study.
A rural town in Japan.
Participants who completed the baseline survey (2008-2010) of the Locomotive Syndrome and Health Outcomes in the Aizu Cohort Study (LOHAS) were recruited. Participants were limited to those without comorbidities according to the Charlson comorbidity index. Participants using antibiotics at baseline were excluded. Mental health and physical functioning were assessed using the Mental Health and Physical Functioning domains of the Short-Form 12 Health Survey, and depressive symptoms were assessed using the Mental Health Inventories at baseline.
The main outcome was antibiotic prescriptions found in claims data during 1 year after the baseline survey.
A total of 967 participants were included in the analysis, and 151 (15.6%) participants with at least one missing variable for the confounding factors were excluded, leaving 816 participants for the primary analysis. Among the 816 participants, 65 (8.0%) were newly prescribed at least one antibiotic during the 1-year follow-up period. The most frequently prescribed antibiotics were third-generation cephalosporins (44 prescriptions; 35.5%), macrolides (28 prescriptions; 22.6%), and quinolones (23 prescriptions; 18.6%). A multivariable logistic regression analysis showed an association between higher mental health scores and future antibiotic prescriptions (adjusted odds ratio [AOR], 1.40 per 1 standard deviation [SD] increase; 95% confidence interval [CI], 1.03-1.90), whereas no significant relationship was observed between Physical Functioning scores and future antibiotic prescriptions (AOR, 0.95 per 1 SD increase; 95% CI, 0.75-1.22). During the secondary analysis, adults with depressive symptoms were less likely to be prescribed antibiotics (AOR, 0.27; 95% CI, 0.11-0.70).
Better mental health was associated with increased future antibiotic prescriptions for healthy community-dwelling Japanese adults, suggesting that mentally healthier adults could be a target population for reducing antimicrobial use.
调查心理健康和主观身体功能与未来抗生素处方之间的关联。
前瞻性队列研究。
日本一个农村城镇。
招募了完成 Locomotive Syndrome 和健康结果在 Aizu 队列研究（LOHAS）基线调查（2008-2010 年）的参与者。参与者根据 Charlson 合并症指数被限制为没有合并症的人。基线时使用抗生素的参与者被排除在外。心理健康和身体功能使用 12 项健康调查简表的心理健康和身体功能领域进行评估，抑郁症状使用心理健康量表在基线时进行评估。
主要结果是在基线调查后 1 年内从索赔数据中发现的抗生素处方。
共有 967 名参与者纳入分析，151 名（15.6%）参与者因混杂因素至少有 1 个缺失变量被排除在外，816 名参与者进行了主要分析。在 816 名参与者中，65 名（8.0%）在 1 年随访期间至少新开了一种抗生素。处方最频繁的抗生素是第三代头孢菌素（44 剂；35.5%）、大环内酯类（28 剂；22.6%）和喹诺酮类（23 剂；18.6%）。多变量逻辑回归分析显示，较高的心理健康评分与未来抗生素处方之间存在关联（调整优势比[OR]，每增加 1 个标准差[SD]增加 1.40；95%置信区间[CI]，1.03-1.90），而身体功能评分与未来抗生素处方之间无显著关系（OR，每增加 1 SD 增加 0.95；95%CI，0.75-1.22）。在二次分析中，有抑郁症状的成年人开抗生素的可能性较低（OR，0.27；95%CI，0.11-0.70）。
更好的心理健康与日本健康社区居住成年人未来抗生素处方的增加有关，这表明心理健康较好的成年人可能是减少抗菌药物使用的目标人群。
