门诊抑郁患者的药物品牌偏好及对用药依从性和疗效的影响

Drug brand preference and its effect on medication compliance and efficacy for outpatients with depression

目的调查门诊抑郁患者药物品牌偏好及对用药依从性和疗效的影响,引导患者合理使用有限的医疗资源,实现在安全有效的基础上尽可能经济地合理用药。方法将459例门诊患者按现阶段药品使用情况分为品牌药组和仿制药组。两组患者均进行药物品牌偏好和用药依从性评估。在品牌药组中,选择对品牌偏好高响应度患者,通过用药宣教和心理支持,进行品牌药→仿制药替换干预8周。于换药前、后进行疗效评估。结果 459例门诊患者中约1/3的患者对品牌偏好呈高响应,约2/3的患者对品牌偏好响应低或无。但服用品牌药的患者品牌偏好响应略高于服用仿制药的患者。总体而言,患者对品牌偏好的响应度随着用药时间的延长而逐渐下降。患者的用药依从性尚可,服用品牌药的患者的用药依从性显著高于服用仿制药的患者。相关性分析表明,品牌药组患者的用药依从性与品牌响应度密切相关,与患者年龄、用药疗程呈负相关;仿制药组患者的用药依从性与品牌响应度无关,与受教育程度密切相关,与患者年龄、用药疗程呈负相关。仿制药组用药替换干预前后,抗抑郁疗效及不良反应未见明显差异。结论服用品牌药的患者用药依从性与对品牌响应度呈正相关。采用仿制药替代治疗的患者疗效良好,不良反应轻微。医务人员可开展药物经济学和生物等效性知识的宣教,帮助患者合理使用有限的医疗资源。

Objective To investigate drug brand preference and its effect on medication compliance and efficacy in pa tients with depression, to guide patient＇s rational use of limited medical resources and achieve a safe and effective drug use. Methods 459 outpatients were divided into the brand drug group and the generic drug group according to the current drug therapy stage. The patients in both groups were assessed by drug brand preference and medication compliance. In the brand group, the patients with high brand preference were chosen to replace with generic medication intervention for 8 weeks. Drug education and psychological support were provided to those patients. Evaluation of therapeutic effect was conducted before and after generic replacement. Results About 1/3 patients had high response and 2/3 patients had low or no response to the brand preference. Patients on brand drugs had slightly higher brand preference than patients with generic drugs. Overall, the patients＇ response to brand preference gradually decreased with the duration of treatment. In general, the medication compli ance was acceptable. The patients taking brand drugs displayed significantly higher medication compliance than the patients taking generics. Correlation analysis showed that in brand medicine group, medication compliance was closely related to brand response, but negatively correlated with the patient＇s age and treatment duration. In generics group, patient medication compli ance was not related to brand response, but closely related with the degree of education and negatively related with the patient＇s age and treatment duration. The antidepression medication maintained same effectiveness in the generic group before and after the replacement, and no severe adverse reactions occurred. Conclusion Medication compliance for patients taking branded drugs was associated with brand response. With medication education and psychological support, alternative generic medicine treatment can give good efficacy with very minor side effects. The medical staff should provide medication education including pharmacoeconomics and the biological equivalence to guide the patients with rational use of the limited medical resources.