澳大利亚儿童和青少年的非典型抗精神病药物处方:医疗从业人员调查。

IF 1.3 4区 医学 Q3 PSYCHIATRY Journal of Psychiatric Practice Pub Date : 2024-05-01 DOI:10.1097/PRA.0000000000000785
Pradeep Rao, Hayden Wilson, Simone Mahfouda, Janice W Y Wong, Hugo A E Morandini, Florian D Zepf
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引用次数: 0

摘要

目的:全球儿童和青少年的非典型抗精神病药物处方量不断增加。然而,人们对处方者在使用这些药物前所考虑的临床变量和证据还缺乏准确的了解。虽然已有关于这些药物长期安全性和有效性的经验文献,但有关这些药物在这些低龄群体中使用的文献却相对稀少。在这项研究中,我们调查了澳大利亚公共卫生服务机构的医务人员目前的处方模式:方法:103 名医生完成了一项调查,研究了他们目前为儿童和青少年开具非典型抗精神病药物处方的做法。调查内容包括非典型抗精神病药物的常用处方、适应症、剂量范围、目标症状、治疗持续时间以及在做出治疗决定时使用的证据基础:医生为该年龄组患者开具的非典型抗精神病药物适应症广泛,其中最常见的药物是利培酮、喹硫平和奥氮平。据报告,不良反应是中断治疗的主要原因。一半以上的受访者表示,他们在开始处方时最常参考的指导/证据来源是同伴或专家意见:儿童和青少年因各种适应症而被开具了多种非典型抗精神病药物处方,他们对处方的信心各不相同,相对而言,他们更依赖于 "自己或同伴的经验",而不是高质量的证据。处方者和政策制定者都面临着挑战,需要对这一年龄组进行进一步的 "正面对立 "研究,以确保在治疗效果和安全性之间保持平衡。
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Atypical Antipsychotic Prescribing in Australian Children and Adolescents: A Survey of Medical Practitioners.

Objective: Prescriptions for atypical antipsychotics in children and adolescents are increasing globally. However, a precise understanding of the clinical variables and evidence that prescribers consider before using these agents is lacking. While empirical literature on the long-term safety and efficacy of these medications is available, the literature concerning their use in these younger age groups is relatively sparse. In this study, we examined the current prescribing patterns of medical professionals employed by a public health service in Australia.

Methods: A survey examining their current practice when prescribing atypical antipsychotics to children and adolescents was completed by 103 physicians. Questions were asked about commonly prescribed atypical antipsychotics, indications, dose ranges, target symptoms, duration of treatment, and the evidence base(s) used when making treatment decisions.

Results: Physicians prescribed atypical antipsychotics for a wide range of indications in this age group, with the most common agents being risperidone, quetiapine, and olanzapine. Adverse effects were reported as the main reason for treatment discontinuation. More than half of the respondents indicated that the most common source of guidance/evidence they referred to when initiating prescriptions were peers or expert opinion.

Conclusions: Children and adolescents were prescribed a number of atypical antipsychotics for a variety of indications, with variable perceived confidence and a relatively heavy reliance on "own or peer experience" as opposed to good quality evidence. Challenges exist for both prescribers and policymakers, and further "head-to-head" studies are needed in this age group to ensure that a balance is maintained between therapeutic benefit and safety.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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