儿童和青少年遵守抗精神病药物实验室监测指南:基于人口的研究
Tony Antoniou1,2,3,4, Tianru Wang2, Kathleen Pajer5,6
1Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Frontiers in psychiatry
|May 30, 2023
概括
大多数开始服用抗精神病药物的儿童和青少年缺乏推的代谢监测. 对加拿大指导方针的遵守率很低,这凸显了在儿科精神卫生保健中改善实践的需要.
科学领域:
- 儿科药理学 儿科药理学
- 公共卫生 公共卫生
- 临床疗效研究研究临床疗效研究
背景情况:
- 加拿大关于对接受抗精神病药物治疗的儿童和青少年代谢监测的指南于2011年发表.
- 基于人群的研究对于评估儿童群体遵守安全使用抗精神病药物指南至关重要.
研究的目的:
- 评估安大略省儿童和青少年新发行的抗精神病药物对代谢监测指南的遵守情况.
- 确定与遵守指南相关的社会人口统计学和临床因素.
主要方法:
- 这是一项针对安大略省0-24岁居民的基于人口的研究,他们在2018年4月至2019年3月期间接受了新的抗精神病药物处方.
- 使用Log-Poisson回归来估计基线和后续 (3和6个月) 实验室测试的流行率 (PRs) 和95%置信区间 (CI).
主要成果:
- 只有23.5%的儿童和青少年接受了推的基线代谢监测.
- 较年长的年龄组 (10-24岁),先前的精神健康住院,特定的诊断 (精神分裂症,糖尿病),二胺使用和专家的处方与更高的监测率有关.
- 在那些同时服用兴奋剂的人群中,监测的频率较低.
- 在3个月和6个月后的随访监测率很低 (分别为13.0%和11.4%).
结论:
- 对于接受抗精神病药物治疗的儿童和青少年,遵守代谢监测指南是不理想的.
- 需要进一步的研究,以了解遵守指南的障碍,并制定策略,如临床医师培训和协作模型,以改善监测实践.
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