在德克萨斯州医疗补助计划的产后妇女中使用基于小组的轨迹建模的抗抑郁药坚持
Emma L Pennington1, Jamie C Barner1, Carolyn M Brown1
1Health Outcomes Division, College of Pharmacy, The University of Texas at Austin.
Journal of managed care & specialty pharmacy
|February 6, 2025
概括
产后抗抑郁药的坚持是不理想的,观察到不同的模式. 干预措施应针对年轻女性,黑人,农村地区的妇女,有物质使用障碍或早产,以改善母亲健康结果.
科学领域:
- 生殖健康 生殖健康
- 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:
- 心理健康状况是导致与怀孕有关的死亡的主要原因.
- 抗抑郁药可以改善母亲的心理健康,但坚持是个挑战.
- 关于产后妇女抗抑郁药坚持模式的数据有限.
研究的目的:
- 分析德克萨斯州医疗补助计划中产后妇女的抗抑郁药物使用和坚持轨迹.
- 为了确定与不同程度的产后抗抑郁药坚持相关的因素.
主要方法:
- 从2018年1月到2022年6月,对德克萨斯州医疗补助申请数据的回顾性分析.
- 包括15667名年龄在12-55岁的妇女,她们在产后90天内接受抗抑郁药.
- 基于组的轨迹建模 (GBTM) 评估了270天的坚持模式 (覆盖日数比例).
主要成果:
- 总体而言,抗抑郁药的坚持和持续性低于最佳 (15.9%的坚持率在80%的PDC).
- 确定了五个坚持轨迹组,随着时间的推移,坚持率下降是常见的.
- 诸如年龄较小,黑人种族,农村居住,物质使用障碍和早产等因素与较低的坚持有关.
结论:
- 观察到产后抗抑郁药坚持行为的显著变化.
- 有针对性的干预措施对于改善高风险人群的坚持是至关重要的.
- 针对年轻人,黑人,农村或SUD/早产患者量身定制的坚持策略对于降低孕产妇发病率和死亡率至关重要.
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