中国临床心理学杂志

上海市焦虑障碍患者门诊服药依从性现况调查

作者：杨旭娇宋立升

单位：上海交通大学医学院附属精神卫生中心上海 200030

分类号：R395.2

出版年,卷(期):页码：2018,26(1):86-88

摘要：

目的：调查焦虑障碍患者门诊用药的依从情况，同时探讨各临床特征患者药物依从性之间的差异，为医生制定治疗方案及预测疾病转归提供依据。方法：利用上海市精神卫生中心门诊电子信息系统抽取2011年1月1日-2014年12月31日在门诊确诊为焦虑障碍并首次口服抗焦虑药物治疗的患者，以药物持有率（Medication Posses-sion Ration，MPR）量化患者在随访期内的药物依从性。结果：本研究共纳入患者19，789例，其中男性患者7，965（40.2%）例，女性患者11，824（59.8%）例，年龄18岁~98岁，平均（47±17岁）。随访期内患者的MPR随着时间的推移不断降低，研究开始3个月、6个月、9个月、12个月内患者MPR值分别为0.98（±1.19）、0.67（±0.90）、0.54（±0.78）、0.46（±0.72）；12个月的随访期内只有27.8%（N=5，503）的患者MPR值大于0.5，19.0%（N=3，765）的患者MPR值大于0.8。其中，精神科门诊及心理咨询门诊患者的年MPR值分别为0.51（±0.72）、0.42（±0.69）；男性患者及女性患者的年MPR值分别为0.45（±0.70）、0.46（±0.70）；青年、中年及老年患者的年MPR值分别为0.40（±0.62）、0.47（±0.81）、0.54（±0.72）；广泛性焦虑、惊恐障碍、社交恐怖症患者的年MPR值分别为0.45（±0.71）、0.61（±0.79）、0.37（±0.77）；单药治疗及联药治疗患者的年MPR值分别为0.34（±0.56）、0.51（±0.75）；首次用药选用5-羟色胺再摄取抑制剂（SSRIs）、5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRIs）及其他具有抗焦虑作用精神药物患者的年MPR分别为0.46（±0.69）、0.49（±0.67）、0.43（±0.73）。结论：焦虑障碍患者的药物依从性较低，且各临床特征患者之间药物依从性差异较大。

Objective:To investigate the medication adherence of outpatients with anxiety disorder and the difference between patients dissimilitude in demography or clinical features. Methods:Data were obtained from the outpatient elec-tric information system of Shanghai Mental Health Center and the study started at the first time when the patients took Anx-iolytic drugs from 2011 to 2014. Adherence was measured with a medication possession ratio(MPR). Results:A total of 19, 789 patients with anxiety disorder were enrolled. Among all the patients, 7,965(40.2%) were male and 11,824(59.8%) were female. The average age was 47(±17) years old. Along with the increase of age, MPR of patients decreased. The mean MPR was 0.98(±1.19), 0.67(±0.90), 0.54(±0.78), 0.46(±0.72) on the 3rd month, the 6th month, the 9th month and the 12th month during the follow-up period respectively. Only 27.8%(N=5,503) of patients with MPR ≥ 0.5, 19.0%(N=3,765) of patients with MPR ≥ 0.5 were found during the 12-month follow-up. The annual MPR value of patients with psychiatric outpatient and psychological consultation was 0.51(±0.72) and 0.42(±0.69), respectively; The MPR values of male and female patients were 0.45(±0.70) and 0.46(±0.70); The annual MPR value of young, middle-aged and elderly patients was 0.40(±0.62), 0.47 (±0.81), 0.54(±0.72); The annual MPR values of patients with generalized anxiety, panic disorder and social phobia were 0.45(±0.71), 0.61(±0.79), 0.37(±0.77), respectively; The MPR values of patients treated with monotherapy and combined therapy were 0.34(±0.56) and 0.51(±0.75); First dose selection serotonin reuptake inhibitors(SSRIs), 5-serotonin norepi-nephrine reuptake inhibitors(SNRIs) and other psychotropic drugs in patients in MPR were 0.46(±0.69), 0.49(±0.67), 0.43(±0.73). Conclusion:The medication adherence of anxiety disorder is low, which may be influenced by different clinical char-acteristics.

基金项目：

上海市科委医学引导类项目（15401934300）

作者简介：

参考文献：

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