在2型糖尿病患者中的代谢监测和控制处方第二代抗精神病药物
Jiali Guo1, David R Goldsmith2, Robert O Cotes2
1Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA.
Psychiatry research
|December 31, 2025
概括
在2型糖尿病 (T2D) 患者处方抗精神病药物时,无论药物类型如何,代谢监测下降. 需要采取质量改善措施来解决T2D患者代谢监测率下降的问题.
科学领域:
- 药物监督 药物监督 药物监督
- 代谢健康 代谢健康
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 2型糖尿病 (T2D) 患者处方第二代抗精神病药物 (SGA) 需要每年进行代谢监测.
- 这种监测作为健康计划绩效指标的有效性是不确定的.
- 这项研究研究了对T2D患者的抗精神病药物处方后的代谢监测和控制率.
研究的目的:
- 评估2型糖尿病 (T2D) 患者在开始抗精神病药物治疗后三年内代谢监测和控制率.
- 为了比较患者之间的监测和控制率,患者被处方第二代抗精神病药物 (SGA),第一代抗精神病药物 (FGA) 或两者都没有.
主要方法:
- 利用来自Epic Cosmos的469,503名新诊断T2D (2012-2021) 的成年患者的电子健康记录数据.
- 根据处方对患者进行分类:SGA (6.9%),FGA (4.4%) 或没有 (88.7%).
- 模拟的代谢监测率 (体重,HbA1c,LDL,eGFR) 和控制 (HbA1c ≤8%,BP ≤140/90 mmHg,LDL ≤100 mg/dL) 使用后勤概括估计方程.
主要成果:
- 在第一年,SGA/FGA组的HbA1c和LDL监测低于对照组,尽管体重监测类似.
- 在第一年,SGA/FGA组的eGFR监测率更高.
- 随着时间的推移,所有组的监测率都下降了;代谢控制率很高,但在不同组之间没有差异.
结论:
- 降低T2D患者的代谢监测率发生在抗精神病药物处方的独立性.
- 有机会进行质量改善举措,以加强这种人群的代谢监测.
- 目前的代谢控制率虽然很高,但在抗精神病药物处方组之间没有显著差异.
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