在诊断注意力缺陷/多动障碍之前使用医疗服务:基于人口的匹配病例控制研究
Vibhore Prasad1,2,3, Emma Rezel-Potts4, Patrick White4
1Population Health Science, King's College London, London, UK vibhore.prasad@kcl.ac.uk.
Archives of disease in childhood
|October 30, 2023
概括
患有注意力缺陷/多动障碍 (ADHD) 的儿童和青少年使用医疗保健服务的频率是对照组的两倍. 对身体状况的早期医疗保健联系可能有助于更早地发现ADHD.
科学领域:
- 儿童医疗保健利用情况
- 注意缺陷/多动障碍 (ADHD) 研究研究
- 公共卫生 公共卫生
背景情况:
- 注意缺陷/多动障碍 (ADHD) 是一种影响儿童和青少年 (CYP) 的流行神经发育障碍.
- 了解患有ADHD的CYP患者的医疗保健服务利用模式对于及时诊断和管理至关重要.
- 之前的研究表明,CYP与ADHD和没有ADHD之间的医疗保健准入和需求可能存在差异.
研究的目的:
- 为了比较医疗保健服务的利用率和因CYP与ADHD之间的出勤原因,与匹配的非ADHD对照进行比较.
- 确定在ADHD诊断之前使用医疗保健的特定模式.
- 通过例行医疗保健接触,探索早期发现ADHD的潜力.
主要方法:
- 一项基于人口的匹配病例控制研究,使用与医院记录相关联的英语初级保健电子健康记录 (临床实践研究数据链接,1998-2015年).
- 包括8127名年龄在4岁至17岁的CYP,被诊断患有ADHD,以及40,136名匹配的非ADHD对照.
- 分析了诊断或索引日期前两年的医学诊断,处方和住院/手术.
主要成果:
- 患有ADHD的CYP使用医疗保健服务的频率大约是对照组的两倍 (GP率比:2.0;医院率比:1.8).
- 在CYP与ADHD中,全科医生出勤的最强相关性是"精神和行为障碍" (OR=25.2).
- 对于眼睛,耳朵,鼻子,喉,口腔问题 (OR=1.5),喘 (OR=1.3) 和湿疹 (OR=1.2) 等疾病,也观察到GP出勤率的增加.
结论:
- 与非ADHD同龄人相比,在诊断前两年,患有ADHD的CYP在医疗保健服务的利用率显著更高.
- ADHD与精神/行为障碍和某些身体状况的增加率有关,包括喘和湿疹.
- 常规的医疗保健接触,特别是对身体疾病的治疗,可能是早期识别和诊断儿童和青少年ADHD的宝贵机会.
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