Drug-naïve first-episode schizophrenia spectrum disorders: Pharmacological treatment practices in inpatient units in Hunan Province, China.
Drug-naïve first-episode schizophrenia spectrum disorders: Pharmacological treatment practices in inpatient units in Hunan Province, China.
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DOI：
10.1111/eip.13046
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发表时间：
2021-08
影响因子：
2
通讯作者：
Liu Z
中科院分区：
文献类型：
--
作者：
Zhu M;Ferrara M;Tan W;Shang X;Syed S;Zhang L;Qin Q;Hu X;Rohrbaugh R;Srihari VH;Liu Z
本研究描述了被诊断为首发精神分裂症谱系（FES）障碍的住院患者的抗精神病药物- naïve处方模式以及与偏离中国现行指南的做法相关的因素。纳入了2016年8月1日至2017年8月1日期间湖南省八家精神病院之一的所有7至45岁的住院患者，这些患者首次出现精神分裂症谱系障碍，疾病未治疗持续时间少于18个月。从电子病历中收集人口统计学、临床特征和出院时的处方。采用Logistic回归和随机森林方法对人口统计学和临床因素以及与中国指南偏差之间的关系进行建模。在纳入研究的602名住院患者中，598名（99.3%）患者开了抗精神病药物，没有患者出院时服用长效注射抗精神病药物。121名（20.2%）参与者存在多种药物（超过一种抗精神病药物处方）。处方氯氮平45例（7.5%）。接受多种药物治疗的成年人比接受单一抗精神病药物治疗的成年人更有可能被开高剂量抗精神病药物。13岁以下的未成年人比13岁以上的人更容易接受多种药物和未经批准的抗精神病药物。我们的研究结果表明，大多数住院患者在出院时只开了一种抗精神病药，这与中国的指导方针一致。患有FES的未成年人以及使用多种药物和氯氮平出院的患者可能需要更严格的监测和管理。随着中国国家精神卫生工作计划的实施，这些结果将有助于决策者分配资源和进行改革，以促进FES的最佳实践治疗。
This study describes antipsychotic prescription patterns for drug‐naïve inpatients diagnosed with first‐episode schizophrenia‐spectrum (FES) disorders and factors associated with practices deviating from China's current guidelines. All inpatients aged 7 to 45 years experiencing a first episode of schizophrenia‐spectrum disorder with a duration of untreated illness of less than 18 months and admitted between 1 August 2016 and 1 August 2017 to one of eight psychiatric hospitals in Hunan were included. Demographics, clinical characteristics and prescriptions at discharge were collected from electronic medical records. Logistic regression and random forest methods were used to model relationships between demographic and clinical factors and deviations from China's guidelines. Of the 602 inpatients included in the study, 598 (99.3%) were prescribed antipsychotics, and no patients were discharged on long‐acting injectable antipsychotics. Polypharmacy (more than one antipsychotic prescribed) was present in 121 (20.2%) participants. Clozapine was prescribed to 45 (7.5%) patients. Adults receiving polypharmacy were more likely to be prescribed high‐dose antipsychotics than those receiving a single antipsychotic. Minors under 13 years of age were more likely to receive polypharmacy and unapproved antipsychotics than those older than 13 years. Our findings suggest that most of the inpatients were prescribed a single antipsychotic at discharge, consistent with China's guidelines. Minors with FES and patients discharged on polypharmacy and clozapine may require more intense monitoring and management. With the current implementation of China's National Mental Health Working Plan, these results will assist decision‐makers in allocating resources and conducting reforms to facilitate best practice treatment for FES.
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