Relationship of pharmaceutical promotion to antidepressant switching and adherence: a retrospective cohort study.
Relationship of pharmaceutical promotion to antidepressant switching and adherence: a retrospective cohort study.
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药物推广与抗抑郁药物转换和依从性的关系：一项回顾性队列研究。
DOI：
10.1176/ps.2010.61.12.1232
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Maciejewski,MatthewL
中科院分区：
文献类型：
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作者：
Hansen,RichardA;Chen,Shih-Yin;Gaynes,BradleyN;Maciejewski,MatthewL
患者不依从和早期停止抗抑郁剂治疗是常见的。对消费者和医生的药品促销可能会影响这种行为。本研究的目的是探讨是否促销支出与早期抗抑郁药转换，急性期的坚持，continuationphase adherence.MethodsA回顾性队列研究进行了国家推广支出数据合并与医疗和处方索赔数据从一个大型的国家健康计划附属于i3创新。包括连续投保的成年重度抑郁症患者接受新的抗抑郁药处方的记录：5，010人在评估转换的队列中，4，457人在评估急性期依从性的队列中，1，772人在评估持续期依从性的队列中。通过检查经通货膨胀调整后的直接面向消费者的广告（DTCA）和医生详细说明的支出来估计国家的促销努力。临床指南用于创建治疗结果方面的代理，包括急性期的抗抑郁药转换和依从性以及持续期的依从性。Logistic回归模型估计促销变量和这些outcome.ResultsPatients服用药物，更高度促进医生不太可能切换药物（比值比[OR]=。61)在治疗的急性期更可能粘附（OR= 1.13）。DTCA切换或抗抑郁药adherence.ConclusionsDetailing医生的影响不大，与较低的药物转换率，并在早期抗抑郁药治疗患者的依从性有积极的关系。这一发现表明，某些方面的推广可能对抗抑郁药的使用有有益的影响。（精神病学服务61：1232-1238，2010）
ObjectivePatient nonadherence and early discontinuation of antide-pressant treatment are common. Pharmaceutical promotion to consumers and physicians may influence this behavior. The objectives of this study were to explore whether promotional spending is related to early antidepressant switching, acute-phase adherence, and continuationphase adherence.MethodsA retrospective cohort study was conducted with national promotional expenditure data merged with medical and prescription claims data from a large national health plan affiliated with i3 Innovus. Included were records for continuously insured adults with major depression who received a new prescription for an antidepressant: 5,010 were in the cohort assessed for switching, 4,457 were in the cohort assessed for acute-phase adherence, and 1,772 were in the cohort assessed for continuation-phase adherence. National promotional efforts were estimated by examining inflation-adjusted spending on direct-toconsumer advertising (DTCA) and physician detailing. Clinical guidelines were used to create proxies for aspects of treatment outcomes, including antidepressant switching and adherence in the acute phase and adherence in the continuation phase. Logistic regression models estimated the association between promotional variables and these outcomes.ResultsPatients taking medications that were more highly promoted to physicians were less likely to switch medications (odds ratio [OR]=. 61) and were more likely to be adherent during the acute phase of treatment (OR= 1.13). DTCA had little effect on switching or antidepressant adherence.ConclusionsDetailing to physicians was associated with lower rates of medication switching and had a positive relationship with patient adherence during early antidepressant treatment. This finding indicates that certain aspects of promotion may have beneficial effects on antidepressant use.(Psychiatric Services 61: 1232–1238, 2010)