Prescribing for inpatients with schizophrenia: an international multi-center comparative study.
Prescribing for inpatients with schizophrenia: an international multi-center comparative study.
复制标题
为住院精神分裂症患者开药：一项国际多中心比较研究。
DOI：
10.1055/s-2003-41199
复制
发表时间：
2003
影响因子：
4.3
通讯作者：
P. Gaszner
中科院分区：
文献类型：
--
作者：
István Bitter;James C.;James C.;Gabor S. Ungvari;W. K. Tang;Z. Xiang;A. Iwanami;P. Gaszner
背景
本研究比较了位于中国、日本、匈牙利和美国的六个学术部门对急性住院精神分裂症患者的处方实践。
方法
处方数据的样本429住院病人从六个学术部门收集了随机选择的人口普查日。根据DSM-IV，所有患者均符合精神分裂症的标准，并且患病时间至少为两年。
结果
虽然不同中心的患者在人口统计学和临床特征方面存在差异，但在不同的研究中心，例如，年龄、性别和病程长短，即使在同一个国家，也观察到各中心抗精神病药物和其他精神药物的处方模式存在很大差异（即，例如，抗精神病药物的数量和剂量、非典型和长效抗精神病药物、其他精神病药物、多种抗精神病药物和每日剂量），抗抑郁药使用除外。在大多数情况下，即使调整了受试者的人口统计学和临床特征（年龄、性别和病程），这些差异仍然存在。抗精神病药物通常以每日分次剂量与一种或多种其他精神药物联合使用，包括抗胆碱能药物、抗惊厥药、苯二氮卓类药物和非苯二氮卓类催眠药。抗胆碱能药物的使用更常见于典型的抗精神病药物。日本中心的非典型抗精神病药物使用率最低。日本中心迄今为止抗精神病药物的平均日剂量最高。
结论
结果表明，处方模式在不同的中心不遵循任何具体的指导方针治疗精神分裂症。结果也证实了以前的发现，即精神分裂症的处方实践在中心和国家之间差异很大。发现的一种常见处方模式是非典型抗精神病药物与精神药物（如抗胆碱能药物、催眠药、抗惊厥药和苯二氮卓类药物）联合使用，每日多次给药。
BACKGROUND
This study compares prescription practices for acute inpatients with schizophrenia among six academic departments located in China, Japan, Hungary, and the U.S.
METHODS
Prescription data for a sample of 429 inpatients from six academic departments were collected on a randomly chosen census day. All patients met criteria for schizophrenia according to DSM-IV and had a length of illness of at least two years.
RESULTS
While patients at the different centers varied in their demographic and clinical characteristics, i. e., age, sex, and length of illness, a great variation in prescription patterns for antipsychotic and other psychotropic drugs among centers was observed even within the same country for all the variables studied (i. e., number and dose antipsychotics, atypical and depot antipsychotics, other psychotropic drugs, multiple antipsychotics, and daily dose) except antidepressant use. In most cases these differences persisted even after adjusting for demographic and clinical characteristics (age, sex, and length of illness) of the subjects. Antipsychotics were usually prescribed in divided daily doses in combination with one or more other psychotropic drugs, including anticholinergics, anticonvulsants, benzodiazepines, and non-benzodiazepine hypnotics. Anticholinergic use was more common with typical antipsychotics. Rates of atypical antipsychotic drug use were lowest in the Japanese center. The Japanese center had by far the highest mean daily dose of antipsychotics.
CONCLUSIONS
The results indicate that prescription patterns in different centers do not follow any specific guidelines for the treatment of schizophrenia. The results also confirm previous findings that prescribing practices for schizophrenia vary greatly among centers and countries. A common prescribing pattern found was the use of atypical antipsychotic drugs in combination with psychotropic drugs, such as anticholinergics, hypnotics, anticonvulsants, and benzodiazepines, administered in multiple daily doses.