The appropriateness of routine medication treatment for schizophrenia.
The appropriateness of routine medication treatment for schizophrenia.
复制标题
精神分裂症常规药物治疗的适当性。
DOI：
10.1093/schbul/sbn138
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发表时间：
2010
影响因子：
6.6
通讯作者：
McNagny,Kirk
中科院分区：
文献类型：
--
作者：
Young,AlexanderS;Niv,Noosha;Cohen,AmyN;Kessler,Christopher;McNagny,Kirk
目的：尽管国家指南规定了治疗精神分裂症的适当策略，但这种疾病对临床医生和卫生保健组织提出了挑战。为了改善护理，了解患者接受适当治疗的频率是有用的。大多数评价治疗的研究都是在第一代抗精神病药物作为模式治疗时进行的。鉴于大多数处方现在是第二代药物，本研究介绍了目前的临床问题和适当的治疗在常规practice.Method：2002年和2004年之间，随机抽样的患者（n= 398）进行了采访，在基线和1年在3个退伍军人事务部心理健康诊所。评估症状和副作用。分析研究是否处方与指导方针的患者有显着的精神病，抑郁症，帕金森氏症，静坐不能，迟发性运动障碍，或elevated weight.Results：很少有患者符合抑郁症，帕金森氏症，或静坐不能的标准。共有44%的患者有明显的精神病，11%有迟发性运动障碍，46%超重。27%的精神病患者、25%的迟发性运动障碍患者和2%的体重升高患者的药物治疗是适当的。随着时间的推移，体重升高的管理略有改善。治疗更有可能改善精神科医生有超过12例精神分裂症患者在其casualload.Conclusion：与20世纪90年代相比，门诊患者更有可能有显着的精神病。精神病的适当治疗率没有变化。体重增加已成为一种普遍的副作用，但治疗很少改变体重。有必要采取干预措施，改善精神病和体重的管理。
Objective:Although national guidelines specify appropriate strategies for the treatment of schizophrenia, this disorder presents challenges to clinicians and health-care organizations. To improve care, it is useful to understand how often patients receive appropriate treatment. Most research evaluating treatment was performed when first-generation antipsychotic medications were the modal treatment. Given that most prescriptions are now for second-generation medications, this study describes current clinical problems and the appropriateness of treatment in routine practice.Method:Between 2002 and 2004, a random sample of patients (n= 398) were interviewed at baseline and 1 year at 3 Department of Veterans Affairs mental health clinics. Symptoms and side effects were assessed. Analyses examined whether prescribing were consistent with guidelines in patients with significant psychosis, depression, parkinsonism, akathisia, tardive dyskinesia, or elevated weight.Results:Few patients met criteria for depression, parkinsonism, or akathisia. A total of 44% of patients had significant psychosis, 11% had tardive dyskinesia, and 46% were overweight. Medication was appropriate in 27% of patients with psychosis, 25% of patients with tardive dyskinesia, and 2% of patients with elevated weight. Management of elevated weight improved modestly over time. Treatment was more likely to improve for patients whose psychiatrists had more than 12 patients with schizophrenia in their caseload.Conclusion:Compared with the 1990s, outpatients are more likely to have significant psychosis. The rate of appropriate treatment of psychosis is unchanged. Weight gain has become a prevalent side effect, yet treatment is rarely changed in response to weight. There is a need for interventions that improve management of psychosis and weight.