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口服抗精神病药与长效注射用抗精神病药治疗精神分裂症患者的疗效比较:5 年随访研究。

Oral Versus Long-Acting Injectable Antipsychotic Treatment for People With Severe Schizophrenia: A 5-Year Follow-up of Effectiveness.

出版信息

J Nerv Ment Dis. 2021 May 1;209(5):330-335. doi: 10.1097/NMD.0000000000001299.

Abstract

The objective here is to compare the effectiveness of long-acting injectable antipsychotics (LAI-APs) and oral ones (OAPs) in patients with severe (Global Clinical Impression-Severity ≥ 5) schizophrenia (N = 688). A 5-year follow-up study has been conducted in patients undergoing standard treatment in mental health units (MHUs) or on a severe mental illness program (SMIP). A total of 8.7% of the patients on the SMIP discontinued treatment, whereas 43.6% did so in MHUs (p < 0.0001). In both cases, treatment retention was significantly higher in patients on LAI-APs (p < 0.001). Also, hospital admissions were in both cases fewer among those on LAI-APs (p < 0.001). There was a significant link between suicide attempts and OAP treatment (p < 0.01). Given the relationship between the use of LAI-APs versus oral treatments in achieving higher adherence and less relapses and suicide attempts, the use of second-generation antipsychotics LAIs should be considered more suitable for people with severe schizophrenia.

摘要

本研究旨在比较长效注射抗精神病药(LAI-APs)和口服抗精神病药(OAPs)在重度精神分裂症患者(N=688)中的疗效。在接受精神卫生单位(MHUs)或严重精神疾病计划(SMIP)标准治疗的患者中进行了为期 5 年的随访研究。共有 8.7%的 SMIP 患者停止治疗,而 MHUs 中则有 43.6%的患者停止治疗(p<0.0001)。在这两种情况下,接受 LAI-AP 治疗的患者的治疗保留率显著更高(p<0.001)。此外,接受 LAI-AP 治疗的患者住院治疗也明显减少(p<0.001)。自杀企图与 OAP 治疗之间存在显著关联(p<0.01)。鉴于 LAI-APs 与口服治疗在提高依从性、减少复发和自杀企图方面的关系,第二代抗精神病药 LAI 的使用应被视为更适合重度精神分裂症患者。

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