Johnson R E, McFarland B H
Center for Health Research, Kaiser Permanente Center for Health Research, Portland, OR 97227.
Med Care. 1993 May;31(5):432-44. doi: 10.1097/00005650-199305000-00005.
In this study, exposure to antipsychotic drugs among ambulatory health maintenance organization (HMO) members is described. The diagnoses and mental health utilization associated with their use are explored, and concomitant drug use is investigated. The antipsychotic prescriptions were retrieved from an automated outpatient pharmacy data base for 2 years. Diagnoses for a two-percent sample of users were retrieved from an automated outpatient utilization data base. During the 2 years, 1,959 HMO members received 10,361 prescriptions for antipsychotics. Fifty-eight percent were female, and the mean age of users was 62 years of age. Haloperidol and thioridazine were the most frequently received drugs. Mean annual exposure to antipsychotics was 0.43% of the HMO population; estimated duration of exposure was 170 days; and estimated mean daily dose was 176 mg of chlorpromazine equivalents. Duration of exposure and mean daily dose were directly related. Both were also related to sex and age of users. Antipsychotic users were more likely to be exposed to various therapeutic classes of drugs indicative of chronic diseases. Antipsychotic exposure among ambulatory HMO members appeared to be conservative in terms of prevalence and similar to national experience in terms of daily dose. Estimated days of exposure appeared to place some users at increased risk of developing tardive dyskinesia, and the frequent and varied concomitant drug exposures can complicate treatment.
本研究描述了门诊健康维护组织（HMO）成员中抗精神病药物的使用情况。探讨了与药物使用相关的诊断和心理健康服务利用情况，并调查了合并用药情况。从自动化门诊药房数据库中检索了两年的抗精神病药物处方。从自动化门诊利用数据库中检索了2%的使用者样本的诊断信息。在这两年中，1959名HMO成员接受了10361张抗精神病药物处方。58%为女性，使用者的平均年龄为62岁。氟哌啶醇和硫利达嗪是最常开具的药物。抗精神病药物的年平均使用比例为HMO人群的0.43%；估计暴露时长为170天；估计平均日剂量为176毫克氯丙嗪当量。暴露时长和平均日剂量直接相关。二者也与使用者的性别和年龄有关。抗精神病药物使用者更有可能接触到各类表明患有慢性疾病的治疗药物。就患病率而言，门诊HMO成员中的抗精神病药物使用情况似乎较为保守，就日剂量而言，与全国情况类似。估计的暴露天数似乎使一些使用者发生迟发性运动障碍的风险增加，频繁且多样的合并用药情况可能使治疗变得复杂。
