在初级保健中处方不适当的质子抑制剂 - - 一项与质量圈的观察性研究
Renata Vidonscky Lüthold1,2, Nicole Christin Henz1, Connor Fuhrer3
1Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Swiss medical weekly
|September 28, 2023
概括
在初级保健中使用标志性质子抑制剂 (PPI) 并没有导致大多数患者的抑郁症. 需要更有针对性的干预措施来减少不适当的PPI处方和剂量.
科学领域:
- 药理学 药理学是指药理学的学科.
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 质子抑制剂 (PPI) 经常被处方,其中很大一部分由于缺乏指示或过度剂量而被认为不合适.
- 尽管开展了宣传活动,但药学流行病学研究表明,随着时间的推移,不适当的PPI处方没有减少.
- 一般医生 (GPs) 在意识到不适当的PPI使用后对处方实践的调整仍未得到充分研究.
研究的目的:
- 为了确定在瑞士初级保健中可能不适当的PPI处方的流行率.
- 为了评估标记这些处方的有效性,一般医生在促进PPI在12个月内停止处方.
主要方法:
- 一项涉及瑞士伯尔尼11名全科医生的观察性研究.
- 识别和标记了206名在PPI上治疗≥8周的患者,其中85人被认为有潜在不合适的处方.
- 12个月后对PPI管理变化的后续评估.
主要成果:
- 15%的查患者在PPI上服用了≥8周,其中41%的患者有潜在的不适当的处方 (55%没有迹象,35%的剂量太高).
- 12个月后,只有35%的标记不合适的个人消费药被停止或减少.
- 抑郁症的主要障碍包括缺乏患者讨论,持续的症状和患者不愿意.
结论:
- 在瑞士的初级保健中,可能不合适的PPI处方很普遍.
- 标记处方单独是不够的,以实现PPI绝用在大多数情况下.
- 与患者和提供者共同设计的个性化干预措施对于成功的PPI解药是必不可少的.
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