- 作者：Cristina Farriols ; MDa ; Olivia Ferrá ; ndez ; PhD ; PharmDb ; José ; Planas ; MD ; PhDa ; JPlanas@parcdesalutmar.cat ; Pere Ortiz ; PharmDb ; Sergi Mojal ; BSd ; Ada I. Ruiz ; MD ; PhDc
- 关键词：Palliative care ; depression ; terminal care ; cancer patients ; benzodiazepines ; antipsychotics ; antidepressants
- 刊名：Journal of Pain and Symptom Management
- 出版年：2012
- 期刊代码：166_08853924
- 类别：med
- 出版时间：May, 2012
- 卷：43
- 期：5
- 页码：945-952
- 文件大小：195 K
Context
Psychiatric disorders are frequently underdiagnosed and undertreated in advanced cancer patients.Objectives
To assess changes in the prescription of psychotropic drugs in terminally ill patients.
Methods
All patients with advanced disease receiving palliative care between 2002 and 2009 were eligible. The consumption of benzodiazepines, antipsychotics, and antidepressants for the years 2002, 2006, and 2009 was compared. Data on the percentage and profile of psychotropic drugs prescribed were collected.
Results
The study population included 840 patients (241 in 2002, 274 in 2006, and 325 in 2009). The percentage of patients treated with psychotropic drugs increased from 82.2%in 2002 to 90.2%in 2009 (P = 0.006) and the mean number of drugs per patient from 1.66 in 2002 to 2.16 in 2006 (P = 0.003), and to 2.35 in 2009 (P < 0.001). Benzodiazepines were prescribed to 72.6%of patients in 2002 and 84%in 2009 (P = 0.001), with lorazepam and midazolam as the most frequently used medications. The use of antipsychotics increased from 26.1%in 2002 to 37.2%in 2006 (P = 0.007) and to 40%in 2009 (P = 0.001), with haloperidol and risperidone as the most commonly prescribed. Antidepressants were prescribed to 17.8%in 2002, 28.1%in 2006 (P = 0.006), and 27.1%in 2009 (P = 0.010), with mirtazapine, citalopram, escitalopram, and duloxetine as the most frequent.
Conclusion
Between 2002 and 2009, there was a significant increase in the use of psychotropic drugs and a change in the profile of drugs prescribed.