治疗失败和长期处方风险指南推的催眠药在日本
Masahiro Takeshima1, Kazuhisa Yoshizawa1, Masaya Ogasawara1
1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.
JAMA network open
|April 17, 2024
概括
这项研究发现,与治疗失眠的埃斯索皮克隆相比,索尔皮德姆和特里亚佐拉姆单独治疗失败率较低. 拉梅尔顿显示出更高的失败率,这表明催眠药的有效性在催眠药之间有所不同.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 失眠指南建议使用几种催眠药,但临床效用尚不清楚.
- 确定最有效的催眠药与最小的失败对于患者护理至关重要.
研究的目的:
- 为了确定指南推的催眠药与较低的单一疗法失败率.
- 评估哪些催眠药更有可能被长期处方治疗失眠.
主要方法:
- 使用日本医学数据中心索赔数据库 (2005-2021) 进行回顾性观察队列研究.
- 包括首次处方指南推的催眠单疗法的成年人.
- 分析单一治疗失败 (在6个月内改变/增加催眠药) 和停药.
主要成果:
- 在239,568名成年人中,10.3%的人在6个月内经历单一治疗失败.
- 与埃斯索皮克隆相比,拉梅尔的失效率更高 (AHR 1.23),而佐洛皮德姆 (AHR 0.84) 和特里亚佐拉姆 (AHR 0.82) 的失效率更低.
- 拉梅尔和苏沃雷克桑的停药率高于埃斯索皮克隆.
结论:
- 这项研究强调了在指导方针推的催眠药中单一治疗失败和停药的显著差异.
- 无法控制的混因素限制了对催眠药物药理性质的最终结论.
- 需要进一步的研究来解释诸如失眠严重程度和医生态度等因素.
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