现实世界临床实践中的耐治疗抑郁症:2012年至2022年数据的系统文献综述
Albino J Oliveira-Maia1,2, Ania Bobrowska3, Eric Constant4,5
1Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal.
Advances in therapy
|October 26, 2023
概括
治疗耐药性抑郁症 (TRD) 的现实世界证据有限. 研究表明,TRD患者的疾病负担很高,缓解率很低,这凸显了对有效治疗的未满足需求.
科学领域:
- 精神病学是一个精神病学.
- 临床研究 临床研究
- 流行病学 流行病学
背景情况:
- 耐治疗性抑郁症 (TRD) 影响了至少两次先前抗抑郁药治疗没有反应的个体.
- 对TRD患者的疾病负担和治疗结果的真实数据很少.
- 了解TRD的现实经验对于改善患者护理至关重要.
研究的目的:
- 系统地审查关于TRD成人的疾病负担和治疗结果的现实世界的证据.
- 确定在日常临床实践中管理TRD的趋势和挑战.
- 为TRD提供未来的研究和临床指导方针.
主要方法:
- 进行了一次系统的文献审查,搜索主要数据库 (MEDLINE,Embase,Cochrane,PsycINFO) 的2012年至2022年间发表的研究.
- 包括的研究是现实世界的观察设计 (队列,截面,病例控制,注册) 以英语.
- 提取的数据包括疾病特征,治疗方法,结果和生活质量.
主要成果:
- 包括20项现实研究,揭示TRD患者往往有长期的中度至重度抑郁症.
- 缓解率一般较低,但随着随访时间的延长而有所改善.
- 在TRD定义,干预和结果测量方面的显著异质性限制了定量综合;生活质量很少被评估.
结论:
- 在现实世界实践中,关于TRD定义,评估和监测存在缺乏共识.
- TRD带来了相当大的疾病负担,这表明对更有效的治疗方法的需求显然没有得到满足.
- 未来的研究应该对评估进行标准化,并纳入生活质量措施,以更好地了解患者的负担.
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