在老年患者中,长期持续使用他类药物治疗
Joshua S Benner1, Robert J Glynn, Helen Mogun
1Division of Pharmacoepidemiology & Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Suite 341, Boston, MA 02115, USA. jbenner@post.harvard.edu
JAMA
|July 23, 2002
概括
在老年患者中,长期使用他类药物治疗的持续性显著下降,特别是在前六个月内. 对高风险群体来说,干预措施至关重要,以改善对降胆固醇药物的坚持.
科学领域:
- 老年医学 老年医学
- 心血管药理学心血管药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 有限的数据存在于长期坚持3 - 基-3 - 甲基氨酸辅酶A降解酶抑制剂 (他) 治疗.
- 之前的研究往往涉及短暂的观察期或非代表性的患者群体.
研究的目的:
- 为了研究与他类药物治疗的长期持久性模式.
- 在美国老年人群中确定他类药物坚持的预测因素.
主要方法:
- 在新泽西州对34,501名老年人 (≥65岁) 进行了回顾性队列研究.
- 随着时间的推移,分析药物补充数据 (覆盖日数比例 - PDC).
- 一般化的线性模型用于识别次优持续性 (PDC <80%) 的预测因素.
主要成果:
- 平均PDC随着时间的推移显著下降,在120个月后达到42%.
- 只有25%的患者在5年后保持至少80%的PDC.
- 持续性差的预测因素包括非白人种族,收入较低,年龄较大,并发症,抑郁症,痴呆症和冠心病事件.
结论:
- 在老年人中,他类药物持久性显著下降,特别是在初始治疗阶段.
- 最近开始治疗时,持续性略有改善,但整体长期使用仍然很低.
- 早期干预和针对高风险患者的有针对性的支持是必要的,以提高他类药物的坚持.
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