Noninterventional, Naturalistic, Retrospective Study to Describe Prescription Patterns of Long-Acting Injectable Antipsychotics and the Impact of Introducing a New Atypical Antipsychotic in the Spanish Province of Tarragona Catchment Area.
Noninterventional, Naturalistic, Retrospective Study to Describe Prescription Patterns of Long-Acting Injectable Antipsychotics and the Impact of Introducing a New Atypical Antipsychotic in the Spanish Province of Tarragona Catchment Area.
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DOI：
10.4088/pcc.16m02044
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发表时间：
2017-03-23
影响因子：
--
通讯作者：
Vilella, Elisabet
中科院分区：
文献类型：
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作者：
Gaviria, Ana M;Franco, Jose;Vilella, Elisabet
背景：我们研究了长效注射剂 (LAI) 抗精神病药 (AP) 在治疗精神分裂症中的使用模式和预测因素，以及在西班牙塔拉戈纳省引入新的 LAI（帕潘立酮棕榈酸酯 [帕潘立酮-LAI]）的效果。方法：这项非干预性、自然主义、回顾性研究包括来自大型人群数据库的电子病历数据，该数据库包含 1,646 名被诊断患有精神分裂症的患者。根据ICD-10标准，2011年1月至2013年12月期间接受治疗的精神分裂症。结果：在研究期间，42.0%的患者接受了LAI AP治疗。最常用的初始 LAI 是利培酮（52.0% 的患者）。总共 23% 最初接受口服 AP 治疗的患者转为 LAI AP，这一变化与年龄较小 (P = .001)、未分化精神分裂症 (P = .015)、药物滥用 (P < .001) 以及使用以下药物的神经精神药物治疗相关：抗惊厥药 (P = .004)、抗胆碱能药物 (P < .001) 和安眠药/镇静剂 (P = .03)。从口服 AP 到帕潘立酮-LAI 的变化是由较年轻的年龄预测的 (P < .001)。总体而言，27.5% 的患者改用另一种 LAI AP，其中帕潘立酮-LAI 是 64.7% 病例的首选。最常见的变化涉及服用利培酮-LAI 的患者，其中许多人转为帕潘立酮-LAI（占病例的 85.0%），特别是病程 > 5 年的患者 (P = .019)。 结论：在我们的服务区域，LAI 制剂的使用逐渐增加。这些药物优先用于患有慢性病和有药物滥用史的患者，以及接受神经精神药物治疗的患者。 1 个月的 LAI 制剂常用于年轻患者。
Background: We studied the patterns and predictors of long-acting injectable (LAI) antipsychotic (AP) use in the treatment of schizophrenia and the effect of introducing a new LAI (paliperidone palmitate [paliperidone-LAI]) in the Spanish province of Tarragona.Methods: This noninterventional, naturalistic, retrospective study included electronic medical record data from a large population-based database of 1,646 patients who were diagnosed with schizophrenia according to ICD-10 criteria and treated between January 2011 and December 2013.Results: During the study period, 42.0% of patients were treated with an LAI AP. The most frequently prescribed initial LAI was risperidone (52.0% of patients). A total of 23% of patients initially treated with an oral AP were switched to an LAI AP, a change that was associated with younger age (P = .001), undifferentiated schizophrenia (P = .015), substance abuse (P < .001), and neuropsychiatric comedication with the following agents: anticonvulsants (P = .004), anticholinergics (P < .001), and hypnotics/sedatives (P = .03). The change from an oral AP to paliperidone-LAI was predicted by younger age (P < .001). Overall, 27.5% of patients switched to another LAI AP, and paliperidone-LAI was the preferred option in 64.7% of cases. The most frequent change involved patients taking risperidone-LAI, many of whom transitioned to paliperidone-LAI (85.0% of cases), particularly patients with a disease duration > 5 years (P = .019).Conclusions: There was a progressive increase in the use of LAI formulations in our catchment area. These agents were preferentially prescribed to patients with chronic disease and a history of substance abuse, as well as patients receiving neuropsychiatric comedication. One-month LAI formulations were commonly used in young patients.