口服抗凝药的自我管理和专业抗凝药诊所的管理:随机交叉比较
M E Cromheecke1, M Levi, L P Colly
1Department of Cardiopulmonary Surgery, Academic Medical Centre, University of Amsterdam, Netherlands.
Lancet (London, England)
|August 30, 2000
概括
患者使用便携式设备进行口服抗凝药疗法的自我管理,可提供与专科医院可比的抗凝血控制. 这种方法是可行的,并且受到患者的青,尽管需要更大规模的研究来确认临床结果.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 口服抗凝剂治疗虽然对血栓栓塞事件有效,但需要经常监测和剂量调整.
- 便携式设备的进步允许患者自我监测和自我调整抗凝剂剂量.
- 这项研究将患者的自我管理与传统的抗凝血药物诊所管理进行比较.
研究的目的:
- 为了比较自我管理的疗效和患者满意度与口服抗凝剂治疗的传统临床管理.
- 评估患者自我管理在控制抗凝治疗中的可行性.
主要方法:
- 一项随机交叉研究,涉及50名长期接受口服抗凝剂治疗的患者.
- 患者在3个月的自我管理和临床管理期间交替进行.
- 每两周监测一次前血红素时间 (国际规范化比率 (INR)),主要终点是治疗范围内的测量百分比 (+/-0.5 INR单位).
主要成果:
- 在自我管理 (55%的时间范围) 和临床管理 (49%的时间范围) 之间,整体抗凝控制没有显著差异 (p=0.06).
- 在自我管理过程中,更大比例的患者在治疗INR范围内度过了大部分治疗时间.
- 与传统护理相比,自我管理的患者满意度显著更高.
结论:
- 对于服用口服抗凝药的患者来说,INR的自我管理是一种可行的策略,至少可以提供与专业诊所相当的抗凝药控制.
- 患者自我管理与更高的患者满意度有关.
- 需要进一步的研究来评估自我管理对血栓栓塞和出血事件发生率的影响.
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