関連する実験動画
より多くの方が良くない場合:高血圧の患者で,薬の服用が不適切で,治療の強化
Michele Heisler1, Mary M Hogan, Timothy P Hofer
1Veterans Affairs Center for Practice Management and Outcomes Research, VA Ann Arbor Health System, Ann Arbor, MI, USA. mheisler@umich.edu
Circulation
|May 29, 2008
まとめ
高血圧に対する治療の強化はまれで,患者の薬の服用に大きく影響されない. 患者のアデランスと医療従事者の臨床慣性の両方に対処することは,血圧制御を改善するために非常に重要です.
科学分野:
- 心血管医学は,心臓血管医学である.
- 医療サービス 研究 医療サービス
- 薬理学 薬理学とは
背景:
- 高血圧の管理は,患者の不十分な遵守または提供者の臨床惰性のために,しばしば最適以下である.
- 本研究では,高血圧管理における患者による薬剤服用順守と提供者による治療の強化の相互作用を調査しています.
研究 の 目的:
- 高血圧に対する薬剤の強化の流行を決定する.
- 治療の強化に関する患者の服薬順守と医療従事者の決定との関係を調べる.
主な方法:
- 退役軍人保健医療システム内の高血圧患者38,327人を対象とした遡及的なコホート研究.
- 電子薬局の補給データと,高血圧の症例に対する外来患者による初等医療訪問の分析.
- 患者および臨床的要因に調整された多変量分析.
主要な成果:
- 薬剤の加強は,高血圧のイベントのわずか30%で発生しました.
- プロバイダーの強化率は,患者による薬物投与の順守の異なるレベル (リフィールギャップ <20%から60%以上) において最小の変動を示した.
- 患者の遵守は,高いレベルの不遵守でも,治療を強化する提供者の決定にほとんど影響を与えませんでした.
結論:
- 血圧上昇のエピソードの3分の1未満は,提供者による薬剤の強化を促した.
- 患者による薬剤服用の順守は,提供者強化の決定に軽微な影響を及ぼしていることが示されました.
- 効果的な血圧管理には,患者の遵守と医療従事者の臨床慣性の両方を対象とした同時介入が不可欠です.
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