识别和减少在初级保健中不适当使用阿司匹林
Christa Brooker1, Rebekah Compton1, Terri Babineau1
1Department of Family Medicine, University of Virginia, Charlottesville, Virginia, USA.
BMJ open quality
|November 6, 2023
概括
一项质量改善干预发现老年人服用阿司匹林作为初级预防. 教育和提供者审查导致29%的患者停止服用阿司匹林,改善了药物安全性.
科学领域:
- 老年医学 老年医学
- 预防心血管疾病 预防心血管疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 最近的证据质疑阿司匹林在老年人中预防动脉样硬化心血管疾病 (ASCVD) 的安全性.
- 在这个人口群体中识别和管理不适当的阿司匹林使用是至关重要的.
研究的目的:
- 开发一种系统的方法来识别70岁以上接受阿司匹林初级预防的患者.
- 为了教育患者和提供者,更新阿司匹林安全指南.
- 评估这项干预措施对阿司匹林终止处方的影响.
主要方法:
- 在两个家庭医学实践中进行质量改善干预.
- 基于电子医疗记录的图表审查以确定阿司匹林的适用性.
- 共享决策和患者/提供者教育.
- 纵向跟进以评估处方停止率.
主要成果:
- 在70岁以上的361名 (40%) 患者中,有145名在初级ASCVD预防中服用阿司匹林.
- 在9个月后,阿司匹林在42名 (29%) 患者的处方停止.
- 被提供者看的患者在继续服用阿司匹林的几率显著降低 (OR=0.87).
结论:
- 这项研究提出了一种基于EMR的新方法,用于识别和减少老年人不适当使用阿司匹林的情况.
- 该干预成功促进了阿司匹林的停止处方,提高了药物安全性.
- 这种方法可以扩展到更大的群体,以优化初级预防策略.
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