Changes in antipsychotic drug prescribing by general practitioners in the United Kingdom from 1991 to 2000: a population-based observational study
Changes in antipsychotic drug prescribing by general practitioners in the United Kingdom from 1991 to 2000: a population-based observational study
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DOI：
10.1046/j.1365-2125.2003.01905.x
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发表时间：
2003-11-01
影响因子：
3.4
通讯作者：
Jick, H
中科院分区：
文献类型：
--
作者：
Kaye, JA;Bradbury, BD;Jick, H
目的估计的变化频率的使用各种抗精神病药物在英国从1991年至2000年，并与这些变化的患者的characteristics.Methods我们进行了一项以人口为基础的观察性研究，使用的数据从一般的做法，有助于信息的一般实践研究数据库（GPRD）。研究人群包括10-99岁的男性和女性。我们估计每年的使用，首次使用，使用的持续时间，并在一个样本的200例患者，使用各种抗精神病药物的适应症，我们观察这些措施如何改变在过去decades.Results抗精神病药物的年使用率从1991年的10.5千分之12.2千分之2000年，总体增长了16%。男子的增幅（25.2%）大于妇女（2.7%）。与此同时，男性抗精神病药物的新使用率稳定，女性下降了21%。年度使用模式和新使用率之间的差异可归因于过去十年中男性和女性的平均年治疗持续时间增加。英国药物安全委员会（CSM）最近建议仅用于成人精神分裂症的二线治疗的硫利达嗪是整个研究期间最常用的抗精神病药物。从1991年到2000年，在10-69岁的男性和女性中，它的使用在所有抗精神病药物使用中的比例增加，但在老年使用者中减少。超过一半的首次使用抗精神病药物的患者样本中，我们评估的是治疗抑郁症，焦虑状态，惊恐障碍，而不到10%的精神分裂症和其他psychose.Conclusion治疗的抗精神病药物的使用增加了在英国在过去的十年中，主要是由于增加的平均每年使用时间，而不是更高的新的使用率。大多数抗精神病药物的使用似乎是为了治疗非精神病性障碍。硫利达嗪是1991-2000年期间最广泛使用的抗精神病药物，在未来十年内是否会根据CSM最近的建议减少使用，这将是一个有趣的问题。
Aim To estimate changes in the frequency of use of various antipsychotic drugs in the UK from 1991 to 2000 and to relate these changes to patients' characteristics.Methods We conducted a population-based observational study using data from general practices that contribute information to the General Practice Research Database (GPRD). The study population comprised men and women 10-99 years old. We estimated annual use, first-time use, duration of use and, in a sample of 200 patients, indications for use of various antipsychotic drugs, and we observed how these measures had changed over the past decade.Results The annual use of antipsychotic drugs increased from 10.5 per thousand in 1991 to 12.2 per thousand in 2000, an overall increase of 16%. The increase was greater in men (25.2%) than women (2.7%). At the same time, the rate of new use of antipsychotic drugs was stable in men and decreased by 21% in women. The difference between patterns of annual use and rates of new use is attributable to the increasing average annual duration of treatment in both men and women during the past decade. Thioridazine, which the UK Committee on the Safety of Medicines (CSM) recently recommended should be used only for second-line treatment of schizophrenia in adults, was the most commonly prescribed antipsychotic throughout the study period. Its use increased as a proportion of all antipsychotic drug use from 1991 to 2000 in men and women aged 10-69 years, but decreased in older users. More than half of all first-time use of antipsychotic drugs in the sample of patients we evaluated was for treatment of depression, anxiety states, and panic disorders, while less than 10% was for treatment of schizophrenia and other psychoses.Conclusion The use of antipsychotic drugs has increased in the UK during the past decade, primarily due to increased average annual duration of use rather than higher rates of new use. Most antipsychotic drug use appears to have been prescribed to treat nonpsychotic disorders. It will be of interest to see whether the use of thioridazine, which was the most widely prescribed antipsychotic during 1991-2000, decreases during the next decade in response to the recent CSM recommendation.