在全国代表性的门诊患者群体中对循环利尿剂的潜在不适当处方模式的调查
Steven Fosnight1, Mate Michael Soric, Jacob Smearman
1Northeast Ohio Medical University College of Pharmacy, Rootstown, OH.
American journal of therapeutics
|October 11, 2023
概括
循环利尿剂经常被处方用于未经批准的用途,超过65%的患者缺乏基于证据的指示,如心力衰竭. 这强调了临床医生需要优化循环利尿剂的处方,以获得更好的患者结果.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 临床药房实践 临床药房实践
- 基于证据的医学基于证据的医学.
背景情况:
- 循环利尿剂是心力衰竭,慢性病和肝功能障碍中胀的确立治疗方法.
- 有限的证据支持使用循环利尿剂治疗其他疾病,这可能导致风险超过益处.
研究的目的:
- 确定没有确立基于证据的适应症的循环利尿剂处方的比例.
- 确定与可能不适当的循环利尿剂处方相关的因素.
主要方法:
- 全国门诊护理调查 (2013-2016) 的回顾性,横截面分析.
- 包括对成年人 (≥18岁) 处方循环利尿剂的门诊访问.
- 主要终点:可能不适当的处方的频率;次要终点:不适当使用的预测因素.
主要成果:
- 超过65%的循环利尿剂处方 (5,261次中3648次) 是针对没有心力衰竭,慢性病或肝功能障碍的患者.
- 不适当处方的预测因素包括65岁以上的年龄,同时使用通道阻断剂,使用含药物和心脏病专家的访问.
结论:
- 循环利尿剂在没有基于证据的指示的情况下比与它们一起更常被处方.
- 这种处方模式为临床优化和改善患者护理提供了机会.
- 需要进一步的研究来了解这种处方趋势的结果.
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