| アブストラクト | BACKGROUND: Metformin is a pharmacological candidate to mitigate second-generation antipsychotic (SGA)-induced weight gain in patients diagnosed with severe mental illnesses (SMI). OBJECTIVE: To determine the incidence, prevalence and demographic patterns of metformin co-prescription among patients diagnosed with SMI initiating SGAs. To estimate the impact of metformin co-prescription on weight over 2 years post-SGA initiation. METHODS: A cohort study of patients diagnosed with SMI initiating aripiprazole, olanzapine, quetiapine or risperidone in 2005-2019 using primary care data from Clinical Practice Research Datalink. We estimated cumulative incidence and period prevalences of co-prescription and explored prescribing differences by demographic and clinical factors. We compared weight change among patients prescribed an SGA-only versus an SGA plus metformin, accounting for confounders using linear regression. FINDINGS: Among 26 537 patients initiating SGAs, 4652 were ever prescribed metformin and 21 885 were not. The two-year incidence of first metformin prescription was 3.3%. The SGA plus metformin group were more ethnically diverse, had greater social deprivation, more comorbidities and higher baseline weight (mean 90.4 vs 76.8 kg). By 2 years post-SGA initiation, mean weight in the SGA-only group had changed by +4.16% (95% CI -1.26 to +9.58) compared with -0.65% (95% CI -4.26 to +2.96) in the SGA plus metformin group. After confounder adjustment, the 2-year mean difference in weight with metformin co-prescription was -1.48 kg (95% CI -4.03 to 1.07) among females and -1.84 kg (95% CI -4.67 to 0.98) among males. CONCLUSION: Metformin is infrequently co-prescribed, despite apparent efficacy and guidelines. CLINICAL IMPLICATIONS: Primary and secondary care collaboration should be strengthened and barriers to co-prescribing addressed. |
|---|
| ジャーナル名 | BMJ mental health |
|---|
| Pubmed追加日 | 2025/4/3 |
|---|
| 投稿者 | Farache Trajano, Luiza; Hayes, Joseph F; Launders, Naomi; Davies, Neil M; Osborn, David P J; Richards-Belle, Alvin |
|---|
| 組織名 | Division of Psychiatry, University College London, London, UK.;North London NHS Foundation Trust, London, UK.;Department of Statistical Science, University College London, London, UK.;Division of Psychiatry, University College London, London, UK;alvin.richards-belle.21@ucl.ac.uk. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40175159/ |
|---|
