终止长期抗抑郁药的互联网和电话支持:REDUCE集群随机试验
Tony Kendrick1, Beth Stuart2, Hannah Bowers1
1Primary Care Research Centre, School of Primary Care, Population Health & Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton, United Kingdom.
JAMA network open
|June 24, 2024
概括
将互联网和电话支持添加到家庭医生对长期停用抗抑郁药物的审查中是安全的,并略有改善了抑郁症得分. 虽然抗抑郁药停用率没有显著增加,但患者出现了更少的戒断症状和更好的精神健康.
科学领域:
- 临床医学 临床医学
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长期使用抗抑郁药正在增加,引发了人们对超过基于证据的持续时间的担忧.
- 确定安全有效的抗抑郁药停用策略至关重要.
研究的目的:
- 评估将互联网和电话支持添加到家庭医生审查中断长期抗抑郁药治疗的安全性和有效性.
- 为了比较这种综合方法与单独的从业者审查.
主要方法:
- 一个集群随机临床试验,涉及131名英国家庭诊所和330名长期服用抗抑郁药物的成年参与者.
- 参与者符合条件,如果足够好,可以考虑停止治疗,并且复发风险低.
- 干预涉及互联网/电话自我管理支持以及从业人员审查;控制仅接受从业人员审查.
主要成果:
- 这项干预对6个月后的抑郁症评分是不劣的 (PHQ-9:4.0与5.0).
- 停用抗抑郁药的比例相似 (45.5%与41.9%).
- 干预组的抗抑郁药戒断症状显著减少,精神健康改善,尽管差异很小.
结论:
- 将互联网和电话支持添加到抗抑郁药停用实践者审查中是安全的.
- 这种方法在抑郁症,戒断症状和心理健康方面可能有轻微的益处.
- 医生主导的审查对相当一部分愿意停止抗抑郁药物的患者来说是安全有效的.
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