在患有严重精神疾病的门诊患者中,不适当处方的流行率和预测因素
Lisanne Koomen1, Ilona van de Meent2, Floor Elferink2
1UMC Utrecht, Psychiatry, Heidelberglaan 100, Utrecht, 3584CX, The Netherlands.
Therapeutic advances in psychopharmacology
|November 29, 2023
概括
在患有严重精神疾病的门诊患者中,潜在的不适当处方 (PIP) 精神药物是常见的. 女性性别,多药性和社会功能不良预测PIP,需要有针对性的药物审查.
科学领域:
- 精神病学是一个精神病学.
- 临床药房 临床药房
- 老年病的医生 老年病的医生
背景情况:
- 在老年人群中,潜在不适当的处方 (PIP) 很普遍,增加了不良事件,发病率和死亡率的风险.
- 现有的关于PIP在精神病学中的研究主要集中在老年人和住院患者的环境中.
研究的目的:
- 确定心理药物可能不适当处方 (PIP) 的流行率.
- 在诊断为严重精神疾病的门诊患者中确定PIP的预测因素.
主要方法:
- 一个务实的开放阶段子集群随机试验 (Muva研究) 涉及16岁及以上的患有严重精神疾病的患者.
- 数据收集包括结构化药物采访,验证的问卷 (社会功能,生活质量,精神症状) 和身体测量 (BMI,腰围),随后进行药物评估.
- 统计分析涉及多变量二进制物流回归以确定PIP预测因子和接收器运行特征分析以评估预测模型性能.
主要成果:
- 在75名患有严重精神疾病的门诊患者中,有46.7%的患者发现了潜在的不适当处方 (PIP),非指示的长期使用二是最常见的类型 (34.1%).
- PIP的主要预测因素包括女性性别 (OR=4.88),更多的药物 (OR=1.41) 和较低的社会功能评分 (OR=1.42).
- 综合预测模型表现出高预测准确度,曲线下的面积 (AUC) 为0.88.
结论:
- 心理药物可能不适当处方 (PIP) 的流行率在严重精神疾病的门诊患者中显著高.
- 定期的药物审查对于识别和减轻PIP至关重要,特别关注女性患者,多种药物使用者和社会功能受损的个人.
- 这些发现强调了需要有针对性的干预措施,以提高心理药物药物安全性在这个弱势群体.
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