Huntington's Disease: Current Epidemiology and Pharmacological Management in UK Primary Care
Huntington's Disease: Current Epidemiology and Pharmacological Management in UK Primary Care
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DOI：
10.1159/000331912
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发表时间：
2011-01-01
影响因子：
5.7
通讯作者：
Pall, Hardev
中科院分区：
文献类型：
--
作者：
Sackley, Catherine;Hoppitt, Thomas J.;Pall, Hardev
背景：最近的争论表明亨廷顿病 (HD) 可能比之前报道的更为普遍。此外，人们对当前的疾病管理知之甚少。本研究旨在提供流行病学数据并描述英国 HD 的药物治疗。方法：访问初级保健研究数据库来识别 2004 年 1 月 1 日至 2008 年 12 月 31 日期间发生的 HD 病例和流行病例。识别出具有表示明确诊断或可能诊断的 Read 代码的患者，以及具有阳性家族史的未诊断患者。还确定了一部分具有明确诊断和处方药物表明症状出现的患者。流行病学数据进行了估计。确定了 2004 年至 2008 年 HD 患者的药理学处方，并根据英国国家处方集类别对处方频率进行了分组。结果：HD 发病率估计范围为每 10 万人年 0.44 至 0.78 例，HD 患病率范围为每 10 万人年 5.96 至 6.54 例。百分之四十四的药物处方针对中枢神经系统。近一半的 HD 患者服用了抗抑郁药，超过 40% 的患者服用了镇痛药。结论：尽管患病率估计值低于最近辩论中建议的数字，但真实患病率可能远高于之前报道的水平是可行的。药理学管理似乎严重依赖中枢神经系统药物和营养支持。其中许多药物是出于药物主要用途之外的原因而开给 HD 患者的。需要进一步的工作来评估替代管理策略（例如治疗师干预、咨询和组织支持）对患者生活质量的影响。版权所有 (C) 2011 S. Karger AG，巴塞尔
Background: Recent debate suggests Huntington's disease (HD) may be more prevalent than previously reported. In addition, relatively little is known about current disease management. This study aims to provide epidemiological data and describe the pharmacological management of HD in the United Kingdom. Methods: A primary care research database was accessed to identify incident and prevalent HD cases between January 1, 2004, and December 31, 2008. Patients with Read codes denoting a definite diagnosis or possible diagnosis, and undiagnosed patients with a positive family history were identified. A subset of patients with a definite diagnosis and prescribed medication indicating symptom onset was also identified. Epidemiological data were estimated. Pharmacological prescriptions to HD patients from 2004 to 2008 were identified, and prescription frequencies were grouped according to the British National Formulary categories. Results: HD incidence estimates ranged from 0.44 to 0.78 per 100,000 person-years, and HD prevalence ranged from 5.96 to 6.54 per 100,000 of the population. Forty-four percent of pharmacological prescriptions targeted the central nervous system. Nearly half of the HD patients were prescribed antidepressants, and over 40% were prescribed analgesics. Conclusions: Although prevalence estimates fell short of figures suggested in recent debate, it is feasible that the true prevalence may be much higher than previously reported. Pharmacological management appears to rely heavily on central nervous system drugs and nutrition support. Many of these drugs are prescribed to HD patients for reasons other than the medication's primary use. Further work is required to evaluate the impact of alternative management strategies, such as therapist intervention, counselling, and organisation support, on the patients' quality of life. Copyright (C) 2011 S. Karger AG, Basel