相关实验视频
当更多不是更好的时候:在高血压患者中加强治疗,药物坚持不好
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
概括
提供者对高血压的治疗强化是罕见的,并且在很大程度上不受患者药物坚持的影响. 解决患者遵守和提供者临床惯性问题对于改善血压控制至关重要.
科学领域:
- 心血管医学 心血管医学
- 医疗保健服务研究 医疗服务研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 高血压管理往往是低于最佳的,因为患者的坚持不佳或提供者的临床惯性.
- 本研究研究了患者药物坚持和提供者治疗强化在高血压管理中的相互作用.
研究的目的:
- 为了确定高血压的药物强化患病率.
- 为了检查患者药物坚持和提供者加强治疗的决定之间的关系.
主要方法:
- 退伍军人事务卫生保健系统中38327名高血压患者的回顾性队列研究.
- 分析电子药房补充数据和针对高血压事件的门诊初级保健访问.
- 根据患者和临床因素调整的多变量分析.
主要成果:
- 药物强化仅发生在30%的血压升高事件中.
- 提供者强化率在不同水平的患者药物坚持度之间显示出极小的差异 (补充差距<20%至≥60%).
- 患者坚持治疗对医疗服务提供者加强治疗的决定的影响很小,即使不坚持治疗的水平很高.
结论:
- 不到三分之一的血压升高发作促使提供者加强药物治疗.
- 患者对药物的坚持表明对提供者强化决策的影响微不足道.
- 针对患者的坚持和提供者临床惯性同时进行的干预措施对于有效的血压控制至关重要.
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