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首页> 外文期刊>Primary care companion to the journal of clinical psychiatry >Adherence to Antidepressants Is Associated With Lower Mortality: A 4-Year Population-Based Cohort Study
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Adherence to Antidepressants Is Associated With Lower Mortality: A 4-Year Population-Based Cohort Study

机译：对抗抑郁药的依从性与较低的死亡率相关：一项基于人群的4年队列研究

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Objective: Despite the growing use of antidepressants and the potential grave consequences of inadequate treatment, little is known about the impact of adherence to antidepressant treatment on mortality in the general population. The objective of this study was to evaluate the association between adherence to antidepressants and all-cause mortality in a population-based cohort. Methods: Data were extracted from the electronic medical record database of the largest health provider in Israel (53% of the nation’s population) on a total of 251,745 patients aged 40 years and above who filled an antidepressant prescription at least once between 2008 and 2011. The main outcome measure was all-cause mortality during the study period. Adherence was measured as a continuous variable representing possession ratio (duration of filled antidepressant divided by duration of prescribed antidepressant). A polynomial model of proportional hazard Cox regression for multivariable survival analysis was used, adjusting for demographic and clinical variables that affect mortality. Results: The association between adherence and the hazard ratio (HR) for mortality follows a quadratic model in which the lowest HR (0.66 [95% CI, 0.64–0.69]) is at a level of 60% adherence in respect to nonadherence. Conclusions: Adherence to antidepressants is significantly associated with a corresponding decrease in the risk of mortality, controlling for relevant covariates. Physicians from all disciplines should actively improve their patients’ adherence to antidepressants since their persistent use is associated with increased survival.
机译：目的：尽管抗抑郁药的使用日益增多，而治疗不足可能带来严重后果，但对于坚持抗抑郁药治疗对普通人群死亡率的影响知之甚少。这项研究的目的是评估以抗抑郁药的依从性与以人群为基础的全因死亡率之间的关系。方法：从以色列最大的医疗服务提供者（占全国人口的53％）的电子病历数据库中提取数据，该研究共计251,745名40岁及40岁以上的患者在2008年至2011年期间至少填写了一次抗抑郁药处方。主要结果指标是研究期间的全因死亡率。粘附力以代表占有率的连续变量来衡量（填充的抗抑郁药的持续时间除以处方抗抑郁药的持续时间）。使用了用于多变量生存分析的比例风险Cox回归的多项式模型，并调整了影响死亡率的人口统计学和临床​​变量。结果：依从性和死亡率的危险比（HR）之间的关联遵循一个二次模型，其中相对于不依从性而言，最低的HR（0.66 [95％CI，0.64-0.69]）依从性为60％。结论：坚持抗抑郁药与控制相关协变量的死亡风险相应降低显着相关。所有学科的医师应积极改善患者对抗抑郁药的依从性，因为持续使用抗抑郁药会增加生存率。

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