Inoue Takeshi, Sano Hiromi, Kojima Yoshitsugu, Yamada Sakiko, Shirakawa Osamu
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan.
Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Osaka, Japan.
Neuropsychiatr Dis Treat. 2021 Mar 18;17:821-833. doi: 10.2147/NDT.S299005. eCollection 2021.
This study aimed to describe real-world treatment patterns and medication adherence among patients with bipolar disorder (BD) in Japan.
Adult patients with a BD diagnosis were identified between July 2013 and February 2018, using an employment-based health insurance claims database from the JMDC Inc. Treatment patterns of target drugs (mood stabilizers, antipsychotics) and adherence (measured by the proportion of days covered [PDC]) were assessed during the first- through third-year follow-up. Adherence was also assessed for patient subgroups.
The analyzed population included 13,788 patients with BD. They were mostly prescribed sodium valproate, lithium, or aripiprazole (range: 21.1-27.4%) across 3 years of follow-up, whereas lamotrigine was prescribed to 11.2-12.8% of patients. Benzodiazepines (70-87%) and antidepressants (52-71%) were commonly prescribed during all three follow-up periods. The mean PDC among all patients with BD was 0.51 during the first and increased to 0.61 during the third year. The mean PDC was 0.42 (first year) in patients aged <30 years and 0.49 in those aged 30-40 years. The PDC was 0.44-0.61 (depending on the drug class) in those who were prescribed a single-class target drug and 0.68-0.83 in those prescribed two drug classes concomitantly.
This study documented generally low medication adherence among patients with BD, and those at young age. These patients may require more attention.
本研究旨在描述日本双相情感障碍（BD）患者的实际治疗模式和药物依从性。
利用JMDC公司基于就业的健康保险理赔数据库，在2013年7月至2018年2月期间识别出诊断为BD的成年患者。在第一年至第三年的随访期间，评估目标药物（心境稳定剂、抗精神病药物）的治疗模式和依从性（通过覆盖天数比例[PDC]衡量）。还对患者亚组的依从性进行了评估。
分析人群包括13788例BD患者。在3年的随访期间，他们大多被处方丙戊酸钠、锂盐或阿立哌唑（范围：21.1 - 27.4%），而拉莫三嗪的处方率为11.2 - 12.8%。在所有三个随访期内，苯二氮䓬类药物（70 - 87%）和抗抑郁药（52 - 71%）的处方很常见。所有BD患者的平均PDC在第一年为0.51，在第三年增至0.61。年龄<30岁的患者平均PDC在第一年为0.42，30 - 40岁的患者为0.49。单药治疗组患者的PDC为0.44 - 0.61（取决于药物类别），联合两种药物治疗组患者的PDC为0.68 - 0.83。
本研究记录了BD患者总体药物依从性较低，尤其是年轻患者。这些患者可能需要更多关注。
