Alexander Singer, Leanne Kosowan, Dhasni Muthumuni, Alan Katz, Hasan Zafari, Farhana Zulkernine, J Don Richardson, Morgan Price, Tyler Williamson, John Queenan, Jitender Sareen
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引用次数: 0
摘要
背景:创伤后应激障碍(PTSD创伤后应激障碍(PTSD)具有显著的发病率和经济成本。本研究利用初级医疗电子病历(EMR)数据描述了创伤后应激障碍患者的患病率和特征:这项回顾性横断面研究使用了加拿大初级医疗哨点监测网络(CPCSSN)的 EMR 数据。这项研究包括加拿大 7 个省的 1,574 家初级医疗机构。2017年1月1日至2019年12月31日期间,共有689301名患者到CPCSSN医疗机构就诊。我们使用描述性统计、卡方和多元逻辑回归模型描述了创伤后应激障碍与患者特征之间的关联:在纳入的 689,301 名患者中,有 8817 人(1.3%,95% CI 1.2-1.3)被诊断为创伤后应激障碍。经多重逻辑回归分析,与无上述情况的患者相比,患有抑郁症(OR 4.4,95% CI 4.2-4.7,P <0.001)、酗酒/依赖(OR 1.7,95% CI 1.6-1.9,P <0.001)和/或药物滥用/依赖(OR 2.6,95% CI 2.5-2.8,P <0.001)的患者患创伤后应激障碍的几率明显更高。与最贫困地区的患者相比,居住在物质最匮乏(OR 2.1,95% CI 1.5-2.1,P <0.001)或社会最贫困(OR 2.8,95% CI 2.7-5.3,P <0.001)社区的患者被诊断为创伤后应激障碍的几率更高:加拿大初级医疗中创伤后应激障碍的发病率为 1.3% (95% CI 1.25-1.31)。通过使用电子病历记录,我们证实在初级医疗机构中,创伤后应激障碍与其他精神健康问题同时存在,这表明改善筛查和循证资源对管理创伤后应激障碍大有裨益。
Characterizing primary care patients with posttraumatic stress disorder using electronic medical records: a retrospective cross-sectional study.
Background: Posttraumatic stress disorder (PTSD) has significant morbidity and economic costs. This study describes the prevalence and characteristics of patients with PTSD using primary care electronic medical record (EMR) data.
Methods: This retrospective cross-sectional study used EMR data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). This study included 1,574 primary care providers located in 7 Canadian provinces. There were 689,301 patients that visited a CPCSSN provider between 1 January 2017 and 31 December 2019. We describe associations between PTSD and patient characteristics using descriptive statistics, chi-square, and multiple logistic regression models.
Results: Among the 689,301 patients included, 8,817 (1.3%, 95% CI 1.2-1.3) had a diagnosis of PTSD. On multiple logistic regression analysis, patients with depression (OR 4.4, 95% CI 4.2-4.7, P < 0.001), alcohol abuse/dependence (OR 1.7, 95% CI 1.6-1.9, P < 0.001), and/or drug abuse/dependence (OR 2.6, 95% CI 2.5-2.8, P < 0.001) had significantly higher odds of PTSD compared with patients without those conditions. Patients residing in community areas considered the most material deprived (OR 2.1, 95% CI 1.5-2.1, P < 0.001) or the most socially deprived (OR 2.8, 95% CI 2.7-5.3, P < 0.001) had higher odds of being diagnosed with PTSD compared with patients in the least deprived areas.
Conclusions: The prevalence of PTSD in Canadian primary care is 1.3% (95% CI 1.25-1.31). Using EMR records we confirmed the co-occurrence of PTSD with other mental health conditions within primary care settings suggesting benefit for improved screening and evidence-based resources to manage PTSD.
期刊介绍:
Family Practice is an international journal aimed at practitioners, teachers, and researchers in the fields of family medicine, general practice, and primary care in both developed and developing countries.
Family Practice offers its readership an international view of the problems and preoccupations in the field, while providing a medium of instruction and exploration.
The journal''s range and content covers such areas as health care delivery, epidemiology, public health, and clinical case studies. The journal aims to be interdisciplinary and contributions from other disciplines of medicine and social science are always welcomed.