Analysis Of Drug Use Status And Compliance Of Patients With Anxiety Disorder In Luoyang Mental Health Center

BackgroundAnxiety disorder is a more common group of mental illnesses.The treatment of anxiety disorders is the focus of psychiatry in various countries.At present,there are few studies on whether the clinical use of the disease is reasonable and compliance with out-of-hospital medications during consolidation and maintenance.The purpose of this study is to analyze the medication statistics of inpatients with anxiety disorders in a tertiary psychiatric hospital in our province,and to follow up the prescriptions for continued medication after the above patients are discharged from the hospital.Combined with questionnaire surveys,subjective and objective assessment of patient compliance with medication To understand the actual situation of drug treatment and compliance of continuous medication in patients with anxiety disorder,and guide clinical practice.ObjectiveTo understand the current status of drug use in hospitalized patients with anxiety disorder,and to analyze the rationality of clinical medication through investigation of the current situation of drug use in conjunction with the"Guidelines for the Prevention and Treatment of Anxiety Disorders"?Editor Wu Wenyuan?;Combined with the questionnaire to make multi-dimensional medication compliance evaluation analysis,to provide a basis for improving rationality and compliance of medication.MethodsThe information of hospitalization orders from a mental health center in our province from June 2013 to June 2018 was selected.The subjects met the diagnostic criteria of"ICD-10"terror anxiety disorder?F40?and other anxiety disorders?F41?.Drug use questionnaire,through medical record survey,to summarize the choice of treatment drugs during hospitalization,and compare the three subtypes recommended by China's guidelines with clear levels:panic disorder,social anxiety disorder and generalized anxiety disorder compared with clinical medications,Find out the rationality and deficiencies of clinical drug use;by extracting and summarizing the outpatient drug information after the above patients are discharged,and applying the drug coverage days to convert the drug holding rate to objectively reflect the patient's drug compliance;summarize and analyze the revised drug compliance The questionnaires reflect subjective medication adherence subjectively;use statistical regression analysis to identify independent factors and related factors that influence patient medication adherence to provide a basis for optimal treatment.Results1.Of the 815 inpatients with anxiety disorders collected from June 2013 to June 2018,671 met the survey criteria,including 375 males?55.9%?and 296 females?44.1%?;admission and discharge There were 142 patients diagnosed with terror anxiety disorder?21.2%?,and a total of 529 other anxiety disorders?78.8%?.220 cases were treated for the first time?32.8%?,and 451 cases were receiving medication at the time of admission?67.2%?.2.Judging from the selection of drugs for treating anxiety disorders,the top two frequency of benzodiazepine anxiolytic drugs are alprazolam?32.3%vs 30.4%?and clonazepam?24.7%vs 26.2%?,The 5-HT1A receptor partial agonist with higher frequency of admission and discharge was buspirone?262 cases of admission vs 269 cases of discharge?;the most frequently used antidepressant was amitriptyline hydrochloride?30.1%vs 28.8%?,paroxetine hydrochloride?27.6%vs 27.0%?and citalopram?15.5%vs16.9%?;quetiapine?20.0?is more frequently used in atypical antipsychotics%vs 59.2%)and risperidone?6.2%vs 18.5%?.3.In terms of treatment methods,448 cases?66.8%?and 484 cases?72.1%?were admitted to the hospital and discharged 484?72.1%?,respectively.The combination therapy was used for the first and multiple hospitalizations.The frequency of use of benzodiazepines/selective 5-HT₁A receptor agonist anti-anxiety drugs combined with antidepressants was significantly higher than that at admission?23.6%vs 0%?;antidepressants combined with other auxiliary drugs were also used more frequently There was a large difference at admission?12.7%vs 0%?,which can reflect that the combination of drugs as the first choice for patients with anxiety disorders is often considered by physicians.4.Comparison of clinical medication with three subtypes recommended in the guidelines in China:panic disorder,social anxiety disorder,and generalized anxiety disorder,and found that they fully meet the medication guidelines.The baseline compliance rates of the three subtypes are:62.5%,51.9%,and 86.0%,in which panic disorder hospitalization medications do not meet the guidelines are mainly focused on the combined duration of benzodiazepines,while social anxiety disorder and generalized anxiety disorder are mainly concentrated in benzodiazepine Expansion of the combination time of drugs and the choice of re-inpatient drug types.5.671 inpatients showed compliance in terms of outpatient prescription holding rate after discharge.It was found that the drug holding rate of these patients within 3 months of discharge was relatively high,and thereafter at 6 months,9 months and 12 The monthly holding rate showed a gradual downward trend?48.9%vs 34.7%vs 13.4%vs 1.3%for MPR?0.8 nodes?,which objectively suggests that compliance will gradually decrease.6.Collected 646 questionnaires and found that after single factor analysis,age,work background,monthly income level,drug purchase method,symptom self-perception,doctor-patient relationship,doctor's account,doctor-patient communication,work and rest lifestyle,physical exercise and social support are Related factors affecting patients'medication compliance?all P values<0.05?;through multiple logistic regression analysis,age,symptom self-perception,doctor-patient relationship,medical advice,lifestyle,physical exercise and social support system are the factors that affect patient medication compliance Independent factors?all P values<0.05?.ConclusionsThe treatment of patients with anxiety disorders is mainly based on combined medications.The medications are basically in line with the key grade recommendations of the"Guidelines for the Prevention and Treatment of Anxiety Disorders in China",but there are still some gaps with the guidelines in the combination of benzodiazepines.There are many factors that affect the compliance of patients with out-of-hospital medications,which requires clinical attention.