"非编码"初级保健患者的心理健康多药学:降低处方的影响
Waseem Jerjes1, Daniele Ramsay2, Harvey Stevenson2
1Research and Development Unit, Hammersmith and Fulham Primary Care Network, Richford Street, London W6 7HY, UK.
Journal of clinical medicine
|February 24, 2024
概括
该项目通过降低药物的处方成功减少了心理健康多药,从而改善了患者的心理和身体健康结果. 教育举措提高了患者和临床医生对管理复杂药物治疗方案的理解.
科学领域:
- 临床药房 临床药房
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 心理健康 (MH) 多药,即同时使用多种MH药物,是越来越令人担忧的,特别是在英国.
- 这种做法带来了重大的临床挑战和风险,需要有针对性的干预措施.
- 启动了一项潜在的质量改进项目,以解决初级保健环境中的MH多药学问题.
研究的目的:
- 实施和评估MH多种药物治疗的患者的减产策略.
- 评估药物减少对心理健康控制和身体健康参数的影响.
- 评估患者和临床医生的教育举措的有效性.
主要方法:
- 一个潜在的质量改进项目,利用一个计划-做-研究-行动 (PDSA) 循环模型.
- 包括来自伦敦一家初级保健中心的68名患者,他们正在接受精神药物,辅助药物和增强性MH药物的治疗.
- 通过PHQ-9和GAD-7得分监测心理健康,以及身体健康参数 (BMI,血压,HbA1c等). 在18个月的时间里.
主要成果:
- 处方精神药物和辅助药物的平均数量显著减少.
- 观察到报告的副作用和药物相互作用的减少.
- 在心理健康控制 (PHQ-9,GAD-7) 和身体健康参数方面有明显的改善.
结论:
- 通过结构化的脱离处方方法,可以显著改善MH多药房管理.
- 综合护理模式包括患者教育和临床医师培训,可以产生积极的心理和身体健康结果.
- 这个项目为未来的MH多药房管理策略提供了一个有希望的模型.
更多相关视频
相关概念视频
Drug Therapy
44
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
44
Antidepressant Drugs: MAOIs and Other Agents
230
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
230
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
137
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
137
Antidepressant Drugs: Overview
487
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
487
Psychosis: Goals of Pharmacotherapy
130
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
130
Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
391
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
391


