在因痛风发作住院期间实施治疗到目标的尿酸降低疗法
Mark D Russell1, Louise Ameyaw-Kyeremeh2, Flora Dell'Accio1
1Centre for Rheumatic Diseases, King's College London, London, UK.
Rheumatology (Oxford, England)
|November 6, 2023
概括
一项新的策略显著增加了在住院期间的痛风发作尿酸降低疗法 (ULT) 的启动. 虽然ULT摄入量有所改善,但患者需要进一步整合护理,以达到尿酸目标.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 临床药房 临床药房
背景情况:
- 痛风发作往往导致住院治疗,突出显示需要优化管理策略.
- 尿酸降低疗法 (ULT) 的启动和坚持对于长期的痛风控制至关重要,但在急性发作期间经常不理想.
- 从医院到初级保健的有效过渡对于持续的ULT有效性至关重要.
研究的目的:
- 评估一项旨在改善护理和增加尿酸降低疗法 (ULT) 的新策略,用于治疗因痛风爆发而住院的患者.
- 评估这一策略对ULT发病率,血清尿酸目标达到率和再住院率的影响.
主要方法:
- 使用前性队列研究设计来评估实施的战略.
- 该战略结合了医院内最佳的痛风管理,护士领导的随访和初级保健转移.
- 结果与实施前12个月的回顾性队列和实施后12个月的前性队列进行了比较.
主要成果:
- 新开始接受ULT的患者比例显著增加,从实施前的49.2%增加到实施后的92.3% (aOR 11.5).
- 较大比例的患者在出院后6个月内达到血清尿酸水平≤360μmol/l (26.8%vs10.6%,aOR3.04).
- 痛风发作的再住院率显示出非显著的下降趋势 (实施后9.3%与实施前14.9%).
结论:
- 实施的战略大大改善了住院痛风患者的ULT启动,超过90%的患者接受治疗.
- 虽然ULT启动和尿酸的目标达到有所改善,但对于大多数患者来说,达到酸水平的目标仍然需要加强初级和中等保健合作.
- 这一策略并没有导致因痛风发作而再次住院的病例增加.
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