Pharmacoepidemiol Drug Saf:黑框警告前后 儿童和青少年抗抑郁药处方趋势如何?

2017-10-26 吴星 环球医学

2017年9月,发表在《Pharmacoepidemiol Drug Saf》上的一项时间序列分析,调查了加拿大初级医疗机构在黑框警告前后,儿童和青少年抗抑郁药(AD)处方的趋势和模式。分析结果显示:黑框警告可有效地降低AD处方,但下降并未持续出现了反弹。

2017年9月,发表在《Pharmacoepidemiol Drug Saf》上的一项时间序列分析,调查了加拿大初级医疗机构在黑框警告前后,儿童和青少年抗抑郁药(AD)处方的趋势和模式。分析结果显示:黑框警告可有效地降低AD处方,但下降并未持续出现了反弹。

目的:旨在描述加拿大初级医疗机构在2004年黑框警告前和后,儿童和青少年AD处方的趋势和模式。

方法:加拿大初级医疗机构哨点监测网络(100万多名患者初级医疗资料库)的处方数据用于分析2000~2014年儿童(8~11岁)和青少年(12~18岁)的AD处方。中断时间序列分析用于评估2004年黑框警告对AD处方水平的影响。

结果:2004年黑框警告对AD处方具有显着且立即的影响。然而,AD处方的下降并未持续,5年后,AD处方率反转并开始增加。选择性5-羟色胺再摄取抑制剂为整个研究阶段最常处方的AD药物,从黑框警告前的66%增加到2009年后的83.12%。

结论:黑框警告可有效降低初级医疗机构警告之后约5年的AD处方,但在之后会出现反弹,该反弹提示当前仍需新的关于风险和获益权衡的共识

原始出处

Morkem R, Williamson T, Patten S,et al. Trends in antidepressant prescribing to children and adolescents in Canadian primary care: A time-series analysis. Pharmacoepidemiol Drug Saf. 2017 Sep;26(9):1093-1099. doi: 10.1002/pds.4240.

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    2018-05-19 jj000001
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    2018-06-06 爆笑小医
  5. [GetPortalCommentsPageByObjectIdResponse(id=1787359, encodeId=94e41e873599d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat May 19 10:56:00 CST 2018, time=2018-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937455, encodeId=b6ad193e45552, content=<a href='/topic/show?id=b3252822854' target=_blank style='color:#2F92EE;'>#儿童和青少年#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28228, encryptionId=b3252822854, topicName=儿童和青少年)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Apr 16 20:56:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908338, encodeId=789019083389d, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Aug 12 21:56:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862283, encodeId=e30518622837f, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jun 06 21:56:00 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1722471, encodeId=b46e1e22471f9, content=<a href='/topic/show?id=7ff5549865a' target=_blank style='color:#2F92EE;'>#抑郁药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54986, encryptionId=7ff5549865a, topicName=抑郁药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78fa33270286, createdName=wetgdt, createdTime=Wed May 30 10:56:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996071, encodeId=f85d19960e189, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Jan 22 06:56:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256850, encodeId=40462568505e, content=黑框警告?, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Sun Oct 29 07:24:18 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492196, encodeId=fe6914921962c, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Oct 28 07:56:00 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2018-05-30 wetgdt
  6. [GetPortalCommentsPageByObjectIdResponse(id=1787359, encodeId=94e41e873599d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat May 19 10:56:00 CST 2018, time=2018-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937455, encodeId=b6ad193e45552, content=<a href='/topic/show?id=b3252822854' target=_blank style='color:#2F92EE;'>#儿童和青少年#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28228, encryptionId=b3252822854, topicName=儿童和青少年)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Apr 16 20:56:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908338, encodeId=789019083389d, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Aug 12 21:56:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862283, encodeId=e30518622837f, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jun 06 21:56:00 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1722471, encodeId=b46e1e22471f9, content=<a href='/topic/show?id=7ff5549865a' target=_blank style='color:#2F92EE;'>#抑郁药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54986, encryptionId=7ff5549865a, topicName=抑郁药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78fa33270286, createdName=wetgdt, createdTime=Wed May 30 10:56:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996071, encodeId=f85d19960e189, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Jan 22 06:56:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256850, encodeId=40462568505e, content=黑框警告?, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Sun Oct 29 07:24:18 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492196, encodeId=fe6914921962c, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Oct 28 07:56:00 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2018-01-22 yb6560
  7. [GetPortalCommentsPageByObjectIdResponse(id=1787359, encodeId=94e41e873599d, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat May 19 10:56:00 CST 2018, time=2018-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937455, encodeId=b6ad193e45552, content=<a href='/topic/show?id=b3252822854' target=_blank style='color:#2F92EE;'>#儿童和青少年#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28228, encryptionId=b3252822854, topicName=儿童和青少年)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Mon Apr 16 20:56:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908338, encodeId=789019083389d, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Aug 12 21:56:00 CST 2018, time=2018-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1862283, encodeId=e30518622837f, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jun 06 21:56:00 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1722471, encodeId=b46e1e22471f9, content=<a href='/topic/show?id=7ff5549865a' target=_blank style='color:#2F92EE;'>#抑郁药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54986, encryptionId=7ff5549865a, topicName=抑郁药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78fa33270286, createdName=wetgdt, createdTime=Wed May 30 10:56:00 CST 2018, time=2018-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996071, encodeId=f85d19960e189, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Jan 22 06:56:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256850, encodeId=40462568505e, content=黑框警告?, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Sun Oct 29 07:24:18 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492196, encodeId=fe6914921962c, content=<a href='/topic/show?id=7999553333c' target=_blank style='color:#2F92EE;'>#抗抑郁#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55333, encryptionId=7999553333c, topicName=抗抑郁)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a59b8920619, createdName=wushaoling, createdTime=Sat Oct 28 07:56:00 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-29 sunfeifeiyang

    黑框警告?

    0

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