Trends in Youth Antidepressant Dispensing and Refill Limits, 2000 Through 2009
Trends in Youth Antidepressant Dispensing and Refill Limits, 2000 Through 2009
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DOI：
10.1089/cap.2011.0048
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发表时间：
2012-02-01
影响因子：
1.9
通讯作者：
Debar, Lynn L.
中科院分区：
文献类型：
--
作者：
Clarke, Greg;Dickerson, John;Debar, Lynn L.
背景：在2003-04年美国食品和药物管理局关于自杀行为风险增加的行动后，青少年抑郁症的抗抑郁药(AD)处方呈下降趋势。目的：将对青年AD处方及其相关特征的观察延长至2009年，以确定AD处方是否继续下降、稳定或反弹。设计：回溯性时间序列设计。样本：青少年(n=57,782)，年龄10-17岁。结果：新发(意外事件)和补发广告在2009年持续下降，没有稳定的迹象。然而，在开始接受AD治疗的年轻人中，AD药物的累积供应量在治疗前和治疗后保持一致，这表明累积治疗发作持续时间没有下降--可能是由于在治疗后的每一次新的补充时，供应的天数增加所致。处方医生在警告期后大幅减少了预先批准的补充量。结论：抑郁症青年AD处方配给的减少可能并不反映出那些坚持超过初始处方的年轻人的强化治疗减少。较低的预先授权续药率可能是处方者试图鼓励回访以评估疗效和不良后果。
Background: Antidepressant (AD) dispensing for depression in youth declined in the years following the 2003-04 Food and Drug Administration actions regarding increased risk of suicidal behavior.Objective: To extend observation of youth AD dispensing and associated characteristics through 2009 to determine if AD dispensing continues to decline, has stabilized, or has rebounded.Design: Retrospective time series design. Sample: Youth (n = 57,782) ages 10 to 17 inclusive.Results: Both new (incident) and refill AD dispensing continued to decline through 2009, with no sign of leveling off. However, among youth who started AD treatment the cumulative supply of AD medication remained consistent across the pre- and postperiods, suggesting that cumulative treatment episode duration has not been degraded-possibly as a function of greater days supply with each new refill in the postperiod. Prescribers dramatically curtailed preauthorized refills in the postwarning period.Conclusion: Declines in AD dispensing to depressed youth may not reflect less intensive treatment for those youth who persist beyond the initial dispense. Lower rates of preauthorized refills may have been an attempt by prescribers to encourage return visits to evaluate response and adverse consequences.