心力衰竭患者的药物坚持及其影响因素:一个跨部分研究
Mohamad Jarrah1, Yousef Khader2, Osama Alkouri3
1Department of Internal Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
Medicina (Kaunas, Lithuania)
|May 27, 2023
概括
对约旦心力衰竭患者来说,药物坚持是重要的问题,近一半的患者经历了部分或不良的坚持. 针对患者人口统计学 (如年龄和教育) 的策略对于改善治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 药物经济学 药物经济学
背景情况:
- 心力衰竭 (HF) 是一种慢性疾病,需要长期服用药物.
- 全球HF患者的药物坚持率低于最佳,大约50%的人不坚持处方治疗.
- 了解约旦人等特定人群的坚持障碍对于有针对性的干预至关重要.
研究的目的:
- 评估被诊断患有心力衰竭的约旦患者的药物坚持水平.
- 为了确定影响这种特定患者队列药物坚持的因素.
主要方法:
- 采用了横截面研究设计.
- 从164名参加约旦北部心脏病诊所的心力衰竭患者中收集了数据.
- 使用药物坚持量表来量化坚持水平.
主要成果:
- 只有33.5%的患者表现出很高的药物坚持.
- 相当大的47%的人表现出部分或不良的坚持他们处方的心力衰竭药物.
- 较年轻的患者 (<60岁),受过高等教育的患者,已婚个人,与他人同居的人以及有医疗保险的患者观察到更高的坚持率.
结论:
- 建议以年龄,教育,婚姻状况和保险为重点的以患者为中心的策略,以改善约旦的HF药物服药.
- 在约旦的医疗保健系统中制定和实施可行的,特定于环境的策略对于提高患者的坚持和健康结果至关重要.
相关概念视频
Heart Failure V: Medical Management
16
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
16
Heart Failure VI: Adjunct Therapies
17
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
17
Heart Failure VII: Nursing Interventions
121
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
121
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
471
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
471
Heart Failure Drugs: β-Blockers
394
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
394
Heart Failure Drugs: Diuretics
430
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
430


