患者可访问的工具,用于心血管初级预防的共享决策:平衡长寿的好处与药物无用性的药物
Marianna Fontana1, Perviz Asaria1, Michela Moraldo1
1International Centre for Circulatory Health, National Heart and lung Institute, Imperial College London, UK.
Circulation
|April 19, 2014
概括
许多患者因不实用性,每日药片的不便而停止服用预防药物. 这项研究发现,药物无用性往往超过了他类药物的小寿命增长,特别是在风险较低的人群中.
科学领域:
- 预防心血管疾病预防心血管疾病
- 卫生经济学 卫生经济学
- 行为医学是一种行为医学.
背景情况:
- 初级预防指南往往忽视了患者对药物的厌恶.
- 大多数患者在三年内停止服用初级预防类药物.
- 药物不适用是坚持药物的重要因素.
研究的目的:
- 量化药物不实用的现实世界的分布.
- 计算各种心血管风险层的平均公用事业.
- 为了比较药物无用性与他类药物的预期寿命增长.
主要方法:
- 伦敦360名普通公众的随机抽样.
- 量化药物厌恶作为所需的寿命增长来抵消无用性.
- 在风险概况中,从他类药物治疗中计算出预期寿命增长 (效用).
主要成果:
- 观察到的药物无用性差异很大,从1天到10年以上 (中位数:6个月).
- 对于50岁以上的个人来说,他类药物的平均预期寿命增加在3.6至24.3个月之间.
- 超过25%的受试者患有超过高风险群体平均寿命增长的不实用性.
结论:
- 在初级预防中,不能假定药物无用性是可以忽略不计的.
- 个体患者的不实用性可以超过他类药物的平均寿命益处.
- 未来的研究应该在更大的人群和临床咨询中探索药物无用性.
相关概念视频
Atherosclerosis III: Management
741
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
741
Coronary Artery Disease IV: Preventive Measures
890
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
890
Peripheral Artery Disease III: Interprofessional Care
655
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
655
Hypertension IV: Drug Therapy and Lifestyle Modifications
1.0K
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
1.0K
Cardiovascular Drugs: Classification based on Therapeutic Indications
4.2K
Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However,...
4.2K
Rheumatic Heart Disease III: Medical Management
544
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
544
