亞洲地區處方藥物型態的研究：著重於日本的資料

Research on Asian Prescription Patterns (REAP): Focusing on Data from Japan

自從 2001 年起，亞洲地區的精神科醫師合作完成了各國開立精神科藥物之型態的研究 (Research on Asia Psychotropic Prescription Pattern, REAP)。2001 年至 2004 年參與的國家包括 中國、香港、日本、南韓及台灣等五國或地區，2008 年起印度、馬來西亞、泰國也加入了 這項研究。每位研究者用當初協議好統一的問卷收集了超過 6,000 位精神分裂症病人的處方 （即 2001、2004、2008，每年各約 2,000 名）並拿來分析及比較。結果發現日本的處方與其 他國家相比有明顯的高劑量及複方用藥的特性；且特定藥物的可用性在國與國之間差異極 大；另外各亞洲國家在 2001 年到 2008 年期間處方的藥物大多從第一代抗精神病藥物轉移成 第二代抗精神病藥物，而這些改變也伴隨著副作用及其他精神科用藥使用上的變化，這些 結論已經刊登在超過 30 篇國際期刊上。2004 年 REAP 的成員也開始探究抗憂鬱劑的處方型 態，並在 2013 年做了追蹤，2013 年的研究擴展到 10 個國家參與，包括 40 個精神機構中超 過 200 位精神科醫師共同完成了追蹤。REAP 的目標在於促進亞洲地區已開發及開發中國家 精神科的合作，且 REAP 有潛力增進參與研究國家精神科用藥的處方型態。

Since 2001, Asian psychiatrists have carried out collaborative research on the prescription patterns of psychotropic drugs in Asia (REAP). Investigators, who participated in the survey in 2001 and 2004, were from China, Hong Kong, Japan, Korea, Singapore, and Taiwan. In 2008, investigators from India, Malaysia, and Thailand also joined this research. All investigators collected the data based on a unified questionnaire-based research protocol. More than 6,000 prescriptions of schizophrenic inpatients, (around 2,000 prescriptions each in 2001, 2004, and 2008), were analyzed and compared. The results have yielded that Japan has no-table high-dose antipsychotic prescription and high frequency of polypharmacy than other participating countries and areas, that the availability of particular drugs differs greatly from country to country, and that there has been a major shift in the prescriptions from first-generation antipsychotics (FGAs) to second-generation antipsychotics (SGAs) in all participated Asian countries from 2001 to 2008. This shift has been accompanied by changes in side effects and by the use of other psy-chotropic drugs. These findings have been reported in more than 30 international journals. In 2004, REAP members surveyed the prescription patterns of antide-pressants and did a follow up survey in 2013. More than 200 psychiatrists of 40 psychiatric institutions from 10 countries and areas in Asia participated in the re-cently concluded 2013 survey. The goal of REAP has been to improve prescription patterns of psychotropic drugs in those participated Asian countries. REAP has potential to promote collaborative research in psychiatry among developed and developing countries in Asia.