喘和COPD:与国际指导方针的比较以及比利时的药物服药情况
Natacha Biset1, Mélanie Lelubre1, Stéphanie Pochet1
1Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium.
Pharmaceuticals (Basel, Switzerland)
|July 29, 2023
概括
对喘和COPD吸入治疗的药物坚持因药物类别而异,长效肌肉抗剂的坚持率最高. 一个新的支持服务显示了潜在的好处,但患者接受率很低.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 药物经济学 药物经济学
- 公共卫生 公共卫生
背景情况:
- 喘和COPD是重要的慢性呼吸道疾病,症状控制是减少恶化和疾病进展的关键.
- 有效的管理依赖于适当的治疗选择和患者对处方吸入药物的高度坚持.
- 了解坚持模式和影响因素对于优化患者长期治疗结果至关重要.
研究的目的:
- 评估喘和COPD吸入疗法的药物坚持和持续性.
- 确定影响遵守的因素,包括人口统计,设备类型和新的患者支持服务.
- 根据国际指南 (GINA,GOLD) 对比比利时的吸入药物消费进行分析.
主要方法:
- 从2013年1月到2016年12月使用连续多次间隔测量药物可用性 (CMA) 测量药物坚持度.
- 通过治疗情节 (TE) 评估的治疗持久性.
- 分析影响CMA的因素,包括性别,年龄,设备类型和"新药服务" (NMS) 的采用.
主要成果:
- 在药理学类别中,坚持性差异很大:吸入性皮质类固醇 (ICS) /长效β激动剂 (LABA) 的坚持性最低,而长效肌抗体 (LAMA) 和LABA/LAMA组合的坚持性最高.
- "新药服务" (NMS) 似乎对坚持药物治疗产生了积极的影响,尽管提供面试的患者完成率低,整体使用率低.
- 分析了比利时人口吸入药物的消费,并与GINA和GOLD建议进行了比较.
结论:
- 吸入性皮质类固醇/长效β-激动剂疗法在喘和COPD中表现出较低的坚持性和持久性,而不是长效肌类抗体治疗.
- "新药服务"有望改善药物坚持,但其有效性受到低患者参与率和完成率的限制.
- 需要加强患者吸收和持续参与支持服务的战略,以改善慢性呼吸道疾病的坚持和结果.
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