Demographics and clinical characteristics of patients of prescribing psychologists, psychiatrists, and primary care physicians.

Phillip M. Hughes, Joshua D Niznik, Robert E McGrath, Casey R Tak, Robert B Christian, Betsy L. Sleath, Kathleen C. Thomas
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Abstract

To describe the characteristics of patients receiving psychotropic medication from prescribing psychologists, psychiatrists, and primary care physicians. This descriptive study was conducted using private insurance claims of patients from New Mexico and Louisiana receiving psychotropic medications (anticonvulsants, antidepressants, antipsychotics, hypotensive agents, anxiolytics/sedatives/hypnotics, and stimulants) from 2004 to 2021 (N = 307,478). Patient characteristics were captured during the 6 months prior to their first psychotropic medication using administrative information, diagnosis and procedure codes, and medication data. Logistic regression models estimated the associations of patient characteristics with prescriber type. Additional logistic regression models estimated the association of prescriber type with medication classes prescribed. Patients were most likely to see specialists (psychologists or psychiatrists) if they had bipolar disorder (average marginal effect and 95% CI 0.214 [0.196, 0.231]), schizophrenia/psychotic disorders (0.118 [0.097, 0.138]), or had 1-4 visits of psychotherapy (0.267 [0.258, 0.026]). Specialist patients were most likely to see a prescribing psychologist if they had 1-4 visits of psychotherapy (0.196 [0.183, 0.210]) or had insomnia (0.309 [0.203, 0.415]). Prescribing psychologists were more likely to prescribe antidepressants (0.028 [0.011, 0.045]) and less likely to prescribe antipsychotics (-0.016 [-0.020, -0.012]) than psychiatrists. Primary care physicians were less likely to prescribe all psychotropic medications except antidepressants (0.011 [0.002, 0.019]) and anxiolytics (0.074 [0.067, 0.080]). Prescribing psychologists treat patients who are more similar to those of psychiatrists than patients of primary care physicians; they are less likely to prescribe antipsychotics and more likely to prescribe antidepressants. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
开处方的心理学家、精神科医生和初级保健医生的患者人口统计学和临床特征。
描述从开具处方的心理学家、精神科医生和初级保健医生处接受精神药物治疗的患者的特征。本描述性研究使用了新墨西哥州和路易斯安那州 2004 年至 2021 年期间接受精神药物(抗惊厥药、抗抑郁药、抗精神病药、降血压药、抗焦虑药/镇静剂/催眠药和兴奋剂)治疗的患者的私人保险索赔(N = 307,478)。利用管理信息、诊断和程序代码以及用药数据采集了患者首次服用精神药物前 6 个月的特征。逻辑回归模型估计了患者特征与处方者类型之间的关联。此外,逻辑回归模型还估算了处方医生类型与处方药物类别之间的关系。如果患者患有双相情感障碍(平均边际效应和 95% CI 0.214 [0.196, 0.231])、精神分裂症/精神病性障碍(0.118 [0.097, 0.138])或接受过 1-4 次心理治疗(0.267 [0.258, 0.026]),则最有可能去看专科医生(心理学家或精神科医生)。专科患者如果接受过 1-4 次心理治疗 (0.196 [0.183, 0.210]),或患有失眠症 (0.309 [0.203, 0.415]),则最有可能去看处方心理医生。与精神科医生相比,开处方的心理学家更倾向于开抗抑郁药(0.028 [0.011, 0.045]),开抗精神病药(-0.016 [-0.020, -0.012])的可能性较低。除抗抑郁药(0.011 [0.002, 0.019])和抗焦虑药(0.074 [0.067, 0.080])外,初级保健医生开具所有精神药物处方的可能性较低。与初级保健医生的病人相比,开处方的心理学家所治疗的病人与精神科医生的病人更为相似;他们开抗精神病药的可能性较小,而开抗抑郁药的可能性较大。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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