在患有抑郁症的患者中,抗抑郁药治疗策略和医疗保健利用
Phuong Tran1, Susan dosReis1, Eberechukwu Onukwugha1
1University of Maryland School of Pharmacy, Baltimore.
Journal of managed care & specialty pharmacy
|November 29, 2024
概括
对于没有反应的抑郁症治疗患者,添加非典型的抗精神病药物 (增强剂) 导致更多的门诊访问,而不是结合抗抑郁药物. 在这些策略中,医疗保健利用率有很大差异.
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
- 精神病学是一个精神病学.
背景情况:
- 抑郁症治疗通常需要调整当最初的抗抑郁药是无效的.
- 策略包括切换,结合抗抑郁药,或增加非典型抗精神病药物.
- 之前对这些策略的研究产生了相互矛盾的疗效和安全性数据,对医疗保健利用的影响尚不清楚.
研究的目的:
- 为了比较患有抑郁症的个人在初始抗抑郁药物治疗后经历了不同的治疗调整后的医疗利用率.
- 具体比较切换,结合和增强治疗策略.
主要方法:
- 使用大型健康计划索赔数据库 (IQVIA PharMetrics Plus) 的回顾性队列研究.
- 包括10-64岁的抑郁症患者开始服用新抗抑郁药 (2016年1月至2020年12月) 和随后的治疗变化.
- 使用回归模型评估治疗后180天内医疗保健利用率 (门诊,住院,急救诊所) 的变化.
主要成果:
- 在3847名患者中,62.9%的人转换了抗抑郁药,33.0%的人结合了抗抑郁药,4.2%的人增加了抗抑郁药.
- 增强组显示出明显更高的门诊访问率 (aRR=1.14) 比组合组.
- 在转换/增强和组合组之间,没有发现住院或急诊室访问的显著差异.
结论:
- 抗抑郁药的增强,虽然不太常见 (4%),与结合治疗相比,与门诊医疗利用率的增加有关.
- 这些发现突出了基于抑郁症治疗调整策略的不同医疗保健利用模式.
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