抽动障碍患儿药物治疗依从性的系统评价  

Systematic review of medication adherence in children with tic disorder

作　　者：程晓 杨春松[2,3] 张川[2,3] 张伶俐[1,2,3] CHENG Xiao;YANG Chunsong;ZHANG Chuan;ZHANG Lingli(West China School of Pharmacy,Sichuan University,Chengdu 610041,P.R.China;Department of Pharmacy/Evidence-Based Pharmacy Center,West China Second University Hospital,Sichuan University,Chengdu 610041,P.R.China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西药学院,成都610041 [2]四川大学华西第二医院药学部/循证药学中心,成都610041 [3]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中国循证医学杂志》2021年第5期586-592,共7页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金项目(编号:71704123);四川省科技厅项目(编号:2020YFS0035)。

摘　　要：目的系统评价抽动障碍患儿药物治疗的依从性,以期辅助临床选择抽动障碍治疗方案,提高抽动障碍药物治疗的疗效。方法计算机检索Medline(Ovid)、EMbase(Ovid)、The Cochrane Library、PsycINFO(EBSCOhost)、CINAHL Plus(EBSCOhost)、CNKI、WanFang Data和VIP数据库,搜集评价抽动障碍患儿药物治疗依从性的临床研究,检索时限均从建库至2020年8月。由2名研究者独立筛选文献,提取依从性定义、依从率和依从性影响因素等关键指标数据,并评价纳入研究的偏倚风险后,对抽动障碍患儿药物治疗依从性进行系统评价。结果共纳入12个研究,包括7个随机对照试验(randomized controlled trial,RCT),2个病例系列研究和3个横断面研究。大部分研究未给出用药依从性的定义。横断面研究表明患儿用药依从性好的比例为29.3%~47.1%。一线治疗药品硫必利、利培酮、阿立哌唑、可乐定的依从性相对较好。药物治疗依从性受药物因素、患者及家属因素和环境因素影响。结论不同研究报告的抽动障碍患儿药物治疗依从率差异较大。少有研究分析抽动障碍药物治疗依从性的影响因素,部分因素是否对药物依从性有影响尚存争议。现有一线治疗药品硫必利、利培酮、阿立哌唑、可乐定的用药依从性较高,可供临床治疗方案参考。Objective To systematically review the medication adherence in children with tic disorder to assist in the selection of clinical treatment options and enhance the efficacy of medications for tic disorder.Methods Databases including Medline(Ovid),EMbase(Ovid),The Cochrane Library,PsycINFO(EBSCOhost),CINAHL Plus(EBSCOhost),CNKI,WanFang Data and VIP were searched from inception to August 2020,and original studies on medication adherence in children with tic disorder were included.Two researchers independently screened literature,extracted data on the definition of compliance,compliance rate,and factors affecting compliance,and evaluated risk bias of included studies.Systematic review was performed to analyze the status of medication adherence in children with tic disorder.Results A total of 12 studies were included,involving seven randomized controlled trials,two case series studies,and three cross-sectional studies.Most studies failed to specify the definition of compliance.The results of cross-sectional studies showed that the proportion of children with good medication compliance was 29.3%to 47.1%.The first-line treatment drugs,tiapride,risperidone,aripiprazole,and clonidine,had relatively good adherence.Medication adherence was affected by drug factors,patient and family factors,and environmental factors.Conclusions The adherence rate of medications for tic disorder varies between studies.Few studies have analyzed the factors that affect medication adherence for tic disorder,and some influencing factors are controversial.The first-line treatment drugs,tiapride,risperidone,aripiprazole,and clonidine,have high medication adherence and are recommended for clinical use.

关 键 词：抽动障碍 药物治疗 依从性 系统评价 

分 类 号：R749.94[医药卫生—神经病学与精神病学]