一项关于患者遵守血液透析的国际研究
A J Bleyer1, B Hylander, H Sudo
1Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1054, USA. ableyer@wfubmc.edu
JAMA
|April 13, 1999
概括
与日本和瑞典的同行相比,接受血液透析的美国患者的遵守率明显较低. 这种血液透析患者的不合规可能会影响国际生存率,需要进一步调查.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 国际医疗保健比较
背景情况:
- 患者在血液透析中的遵从性在国际上有所不同,但这些差异没有得到充分记录.
- 了解这些变化至关重要,因为它们可能会导致不同国家患者存活率的差异.
研究的目的:
- 在不同国家进行对患者遵守血液透析治疗的比较分析.
- 调查国际在遵守血液透析方案方面的差异.
主要方法:
- 一项前性观察性研究,涉及美国 (n=415),日本 (n=194) 和瑞典 (n=84) 的血液透析患者.
- 在美国 (n=49),日本 (n=21) 和瑞典 (n=16) 的医疗保健专业人员 (护士和科医生) 进行了横截面调查,以评估患者的遵守.
- 关键结果指标包括错过透析治疗的百分比和错过治疗的总数.
主要成果:
- 美国患者在六个月内错过了2.3%的处方血液透析治疗,相当于每100个月患者中错过的治疗次数为28.1.
- 相比之下,日本和瑞典的患者在各自研究期间 (P<.001) 每100个患者月有零次 missed hemodialysis治疗.
- 医疗保健专业人员的调查数据证实了这些发现,估计有4%的美国患者错过了每月的治疗,相比之下,日本的0%和瑞典的0.1% (P<.001).
结论:
- 与瑞典和日本相比,美国的患者中不遵守血液透析的患病率要高得多.
- 血液透析患者遵守规定的这些显著的国际差异表明,对生存率的潜在影响,值得进一步深入研究.
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