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Gender differences in medication prescribing patterns for veterans with posttraumatic stress disorder: A 10-year follow-up study
Journal of Traumatic Stress ( IF 2.4 ) Pub Date : 2022-07-07 , DOI: 10.1002/jts.22861
Katherine Hadlandsmyth 1, 2, 3 , Nancy C Bernardy 4, 5, 6 , Brian C Lund 1, 2, 7
Affiliation  

Women veterans with posttraumatic stress disorder (PTSD) have historically received more psychiatric medications than men. The current analysis identified prescribing trends of medications recommended for (i.e., select antidepressants) and against (i.e., benzodiazepines, select antidepressants, antipsychotics, and select anticonvulsants) use in PTSD treatment among women and men in 2010–2019. All veterans receiving care for PTSD in 2019 were identified using national U.S. Department of Veterans Affairs (VA) administrative data. Multivariable logistic regression analyses, adjusted for demographic characteristics and psychiatric comorbidities, were used to contrast the likelihood of receiving a medication class across genders. Sensitivity analyses using identical selection methods were conducted for the calendar years 2010, 2013, and 2016. In 2019, 877,785 veterans received treatment for PTSD within the VA, 13.5% of whom were women. Across medication classes and years, women were more likely to receive all psychiatric medications of interest. Relative to men, women were slightly more likely to receive antidepressants recommended for PTSD in 2019, adjusted odds ratio (aOR) = 1.07, 95% CI [1.06, 1.09]. However, gender differences for medications recommended against use for PTSD were notably larger, including benzodiazepines, aOR = 1.62, 95% CI [1.59, 1.65]; anticonvulsants. aOR = 1.41, 95% CI [1.38, 1.44]; and antidepressants recommended against use for PTSD, aOR = 1.26, 95% CI [1.19, 1.33]. To inform tailored intervention strategies, future work is needed to fully understand why women receive more medications recommended against use for PTSD.

中文翻译:

患有创伤后应激障碍的退伍军人药物处方模式的性别差异:一项为期 10 年的随访研究

历史上,患有创伤后应激障碍 (PTSD) 的女性退伍军人比男性接受更多的精神药物治疗。目前的分析确定了 2010-2019 年女性和男性在 PTSD 治疗中推荐使用(即选择抗抑郁药)和反对(即苯二氮卓类药物、选择抗抑郁药、抗精神病药和选择抗惊厥药)的药物处方趋势。2019 年所有接受 PTSD 治疗的退伍军人都是使用美国国家退伍军人事务部 (VA) 行政数据确定的。多变量逻辑回归分析,根据人口特征和精神病合并症进行调整,用于对比不同性别接受药物治疗的可能性。使用相同的选择方法对 2010、2013 和 2016 日历年进行了敏感性分析。2019 年,877,785 名退伍军人在退伍军人事务部接受了 PTSD 治疗,其中 13.5% 是女性。在药物类别和年份中,女性更有可能接受所有感兴趣的精神科药物。相对于男性,女性在 2019 年接受推荐用于 PTSD 的抗抑郁药的可能性略高,调整后的比值比(a) = 1.07, 95% CI [1.06, 1.09]。然而,建议不要用于 PTSD 的药物的性别差异明显更大,包括苯二氮卓类药物,OR = 1.62, 95% CI [1.59, 1.65];抗惊厥药。OR = 1.41 , 95% CI [1.38, 1.44];和抗抑郁药推荐不要用于 PTSD,OR = 1.26, 95% CI [1.19, 1.33]。为了告知量身定制的干预策略,未来的工作需要充分理解为什么女性会接受更多建议不要用于 PTSD 的药物。
更新日期:2022-07-07
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