肝硬化患者药物使用率的变化:使用制药益处计划数据的回顾性队列研究
Kelly L Hayward1,2, Rianne A Weersink3, Christina M Bernardes4
1Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
Drugs - real world outcomes
|October 12, 2023
概括
澳大利亚肝硬化患者的药物使用增加,多药药常见. 质子抑制剂 (PPI),阿片类药物和抗生素经常被分发,突出了改善社区环境中药物安全和合理化的需要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
背景情况:
- 安全和适当的药物使用对于改善肝硬化患者的健康结果至关重要.
- 关于澳大利亚肝硬化患者的药物类型和数量存在有限的数据,特别是在社区环境中.
- 这项研究的目的是描述肝硬化患者的处方,并分析药物组使用的趋势.
研究的目的:
- 描述澳大利亚为肝硬化患者开出的处方.
- 在这个人群中随着时间的推移探索药物组使用的变化.
- 确定改善药物安全和合理化的潜在领域.
主要方法:
- 2016年1月至2020年6月的CirCare参与者使用的制药福利计划数据.
- 包括从肝硬化诊断到肝移植或死亡的处方.
- 分析了每6个月间隔的药物使用模式,使用通用估计方程来评估随时间的变化.
主要成果:
- 522名患者获得了89,615份处方,平均每名患者获得了16种独特药物.
- 通常使用的药物包括质子抑制剂 (PPI) (73%),阿片类药物 (68%) 和抗生素 (89%).
- 多药制是普遍存在的 (59-69%使用≥5种独特药物),整体处方使用随着时间的推移而增加 (p < 0.001). 一般医生比专科医生发放的"不安全"药物更多.
结论:
- 多药在肝硬化患者中很常见,可能会过度使用某些药物类别.
- 需要加强药物监测,重点关注社区环境中高风险的处方做法.
- 未来的努力应促进药物合理化,以提高肝硬化患者的安全性.
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