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首页> 外文期刊>Clinical therapeutics >Role of patient experience in atypical antipsychotic adherence: A retrospective data analysis.
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Role of patient experience in atypical antipsychotic adherence: A retrospective data analysis.

机译：患者经验在非典型抗精神病药物依从性中的作用：回顾性数据分析。

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Objective: We report on differences in atypical antipsychotic adherence after the start of outpatient treatment with atypical antipsychotics in patients receiving routine clinical care, based on whether they had been dispensed antipsychotic medication during the previous 180 days. We hypothesized that prior receipt of an antipsychotic prescription would identify patients with a reduced risk for medication discontinuation, perhaps due to greater experience with illness and/or medication experience. Methods: De-identified computerized pharmacy records of 406,032 patients from 1157 pharmacies throughout the United States were used to select patients who were dispensed a noninjectable atypical antipsychotic between October 1, 2003, and March 31, 2004. Patients receiving an atypical antipsychotic prescription during this enrollment period were divided into 2 groups. One group consisted of patients to whom antipsychotic medications had been dispensed in the 180-day period prior to the index outpatient fill. The other group was composed of individuals who had not been dispensed a conventional or atypical antipsychotic during this period. Adherence was measured using Kaplan-Meier time-to-discontinuation analysis during a 360-day follow up period after the enrollment date. Discontinuation was defined as being 30 days late for a scheduled refill. Results: Patients without receipt of an antipsychotic in the 180-day period prior to the index fill composed 32.6% of the total sample of patients (N = 406,432). Women composed 55.2% of the sample; men, 44.8%. The mean age was 43.7 years. In patients previously dispensed an antipsychotic medication, the median time to discontinuation was 125 days, while in patients not previously dispensed an antipsychotic medication, this value was 34 days. Conclusions: In this analysis of data from pharmacy records, past antipsychotic use appeared to be associated with atypical antipsychotic adherence. Patients without evidence of having been dispensed antipsychotic medication during the 180 days prior to the index antipsychotic prescription appeared to have a high risk for medication discontinuation in the first 30 days after the start of outpatient therapy. This finding suggests that close follow-up during that period in patients who are either new to antipsychotic medication or who are being restarted on an antipsychotic after a prolonged lapse in use may be beneficial.
机译：目的：我们根据接受治疗的患者在过去180天内是否已服用抗精神病药物，报告了接受常规临床护理的患者开始接受非典型抗精神病药物门诊治疗后的非典型抗精神病药物依从性差异。我们假设事先收到抗精神病药处方可以识别出停药风险降低的患者，这可能是由于有更多的疾病经验和/或用药经验。方法：使用来自美国1157个药房的406,032位患者的身份不明的计算机化药房记录，选择2003年10月1日至2004年3月31日期间接受非注射非典型抗精神病药物治疗的患者。在此期间接受非典型抗精神病药物治疗的患者招生期间分为2组。一组包括在门诊患者就诊前180天内已分配抗精神病药物的患者。另一组由在此期间未分配常规或非典型抗精神病药的个人组成。在注册日期后的360天内，使用Kaplan-Meier停药时间分析了粘附性。停产被定义为计划的补充时间晚了30天。结果：在指标填写之前的180天内未接受抗精神病药治疗的患者占患者总数的32.6％（N = 406,432）。妇女占样本的55.2％;男性，占44.8％。平均年龄为43.7岁。在先前已分配抗精神病药物的患者中，中位中断时间为125天，而在先前未分配抗精神病药物的患者中，该值为34天。结论：在对药房记录数据的分析中，过去使用抗精神病药似乎与非典型抗精神病药依从性有关。在开始抗精神病药物处方之前的180天内没有证据表明已服用抗精神病药物的患者在门诊治疗开始后的前30天内似乎有很高的药物停用风险。这一发现表明，对于新加入抗精神病药物或长期停用抗精神病药物的患者，在此期间进行密切随访可能是有益的。

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