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[基层医疗中抗抑郁药的长期处方。对公共卫生的影响]

[Long term prescription of antidepressants in primary care. Impact on public health].

作者信息

Madueño-Caro Antonio José, Berro-Ramírez Gonzalo, Chávez-Gata Luis, Torrescusa-Camisón Rubén, Climent-Rodríguez José Antonio, Navarro-Abal Yolanda, Gómez-Salgado Juan

机构信息

Centro de salud La Laguna. Servicio Andaluz de Salud, Cádiz, España.

Facultad de Ciencias del Trabajo, Universidad de Huelva, Huelva, España.

出版信息

Aten Primaria. 2025 Feb 12;57(8):103234. doi: 10.1016/j.aprim.2025.103234.

Abstract

OBJECTIVE

To determine the variables associated with the prescription of long-term antidepressants (more than three years) to patients in a primary health area.

DESIGN

Descriptive observational study. SITE: Basic health area of primary care.

PARTICIPANTS

A sample of 315 participants assigned to a basic health area, who have been prescribed at least one antidepressant during a calendar year.

INTERVENTIONS

Institutional information sources.

MAIN MEASUREMENTS

Those variables that can be associated with a prolonged prescription of antidepressants. The selection of the patients was carried out by simple random sampling. Analysis using Chi-Square contrast for the comparison of proportions. Multivariate binary logistic regression to observe possible associations in the set of variables.

RESULTS

The study analyzed a majority of women (75.2%) with a mean age of 61.7 years (SD=38.18). SSRIs (Selective Serotonin Reuptake Inhibitors) were the most commonly used antidepressants (50.5%), especially sertraline. Dysthymia was the main diagnosis (17%). Prolonged duration of treatment was associated with SSRIs and dysthymia. Logistic regression showed relevant factors: dysthymia, age, number of antidepressants, and SSRI use.

CONCLUSION

There is a high prevalence of prescription beyond three years. It is observed how dysthymic disorder is associated with a prolonged duration of treatment, as well as age, SSRI use, antidepressant change, and the total number of antidepressants prescribed.

摘要

目的

确定与基层医疗区域内患者长期(超过三年)使用抗抑郁药处方相关的变量。

设计

描述性观察性研究。

地点

基层医疗的基本健康区域。

参与者

分配到一个基本健康区域的315名参与者样本,他们在日历年期间至少被开具过一种抗抑郁药。

干预措施

机构信息来源。

主要测量指标

那些可能与抗抑郁药长期处方相关的变量。通过简单随机抽样选择患者。使用卡方检验进行比例比较分析。采用多变量二元逻辑回归观察变量集中可能存在的关联。

结果

该研究分析的大多数为女性(75.2%),平均年龄61.7岁(标准差=38.18)。选择性5-羟色胺再摄取抑制剂(SSRIs)是最常用的抗抑郁药(50.5%),尤其是舍曲林。心境恶劣是主要诊断(17%)。治疗时间延长与SSRIs和心境恶劣有关。逻辑回归显示相关因素有:心境恶劣、年龄、抗抑郁药数量和SSRIs的使用。

结论

三年以上处方的患病率很高。观察到心境恶劣障碍与治疗时间延长相关,同时还与年龄、SSRIs的使用、抗抑郁药更换以及开具的抗抑郁药总数有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb5f/11867236/ec0f72033e4b/gr1.jpg

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