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使用PHQ-9进行抑郁症随访监测:一个开放的集群随机对照试验

Tony Kendrick¹, Christopher Dowrick², Glyn Lewis³

¹School of Primary Care, Population Science, and Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton.

The British journal of general practice : the journal of the Royal College of General Practitioners

|February 26, 2024

概括

使用患者健康问卷 (PHQ-9) 监测抑郁症在初级保健12周后没有改善结果. 需要进一步的研究来探索潜在的长期益处和自动反机制.

科学领域:

初级保健研究研究初级保健研究
心理健康服务心理健康服务
临床试验方法论临床试验方法论

背景情况:

建议对抑郁症治疗进行结果监测,但缺乏证据表明患者在初级保健机构中受益.
现有的指导方针提倡定期评估抑郁症症状,但初级保健的实施及其对患者结果的影响仍未得到充分研究.

研究的目的:

评估使用患者健康问卷 (PHQ-9) 监测抑郁症的有效性,在初级保健中综合患者反.
评估结构化监测协议对26周内抑郁症症状严重程度和生活质量的影响.

主要方法:

一个开放的集群随机对照试验,涉及141个英国的一般实践.
招募新出现抑郁症的成年人,不包括患有痴呆症,精神病,药物滥用或自杀风险的人.
干预组接受了患者健康问卷 (PHQ-9) 监测和反;对照组接受了通常的护理. 主要结局:贝克抑郁症清单 (BDI-II) 在12周.

主要成果:

干预组和对照组在12周内贝克抑郁调查 (BDI-II) 评分没有显著差异 (平均差异 -0.46;95% CI = -2.16至1.26).
在26周的干预组中观察到更高的EuroQol EQ-5D-5L生活质量得分 (调整后的平均差异为0.053;95% CI = 0.013至0.093).
每项协议分析表明,干预组的抗抑郁药使用和心理健康接触显著增加,并记录了PHQ-9的随访.

结论:

该研究没有发现通过初级保健中PHQ-9监测12周后改善抑郁症结果的证据.
在26周观察到的潜在益处需要进一步调查,特别是探索自动监测和教学反机制.
建议进行复制研究,以证实研究结果并阐明抑郁症治疗中潜在的长期改善背后的机制.

关键词:

抑郁抑郁症抑郁症抑郁症是一种心理健康心理健康情绪障碍情绪障碍情绪障碍患者报告的结果衡量患者报告的结果.初级医疗保健是一项主要的医疗保健服务.

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