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在一个大型卫生系统中,探索西班牙裔患者药物坚持和糖尿病差异之间的关系
Kimberly Danae Cauley Narain1,2, Ayan Patel3, Samuel Skootsky4,5
1Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. KNarain@mednet.ucla.edu.
Journal of general internal medicine
|November 14, 2023
概括
与其他群体相比,西班牙裔患者的HbA1c水平较高,药物坚持并不能解释. 需要进一步的研究,以了解超出药物坚持影响糖尿病控制的因素.
科学领域:
- 糖尿病管理 糖尿病管理
- 健康差距 研究 研究 研究 研究
- 临床信息学 临床信息学
背景情况:
- 低于最佳的血红蛋白A1c (HbA1c) 控制有助于西班牙裔患者糖尿病结局的差异.
- 药物坚持的差异是导致HbA1c水平种族/民族差异的潜在因素.
研究的目的:
- 调查加利福尼亚大学卫生系统 (UC Health) 中西班牙裔患者与其他种族/种族群体相比,药物坚持和HbA1c水平差异之间的关联.
主要方法:
- 一项横截面分析利用了UC Health电子健康记录 (2021年1月至12月) 的临床,行政和处方发行数据.
- 线性回归模型 (LRMs) 评估了药物坚持 (覆盖日数比例 - PDC) 与HbA1c水平之间的关系,调整为种族/种族.
- 该研究包括27,542名18至75岁的患者,报告亚裔,西班牙裔或白人种族/种族,糖尿病诊断或药物处方.
主要成果:
- 在不包括药物坚持的模型中,西班牙裔种族与HbA1c水平呈正相关性 (β=0.31,p<0.001).
- 当包括药物坚持 (PDC) 时,它与HbA1c水平 (β=-0.18,p<0.001) 有负相关性.
- 最重要的是,西班牙裔种族和HbA1c水平之间的积极关联保持不变 (β=0.31,p<0.001),表明坚持不解释差异.
结论:
- 通过PDC测量药物坚持,并没有解释西班牙裔患者中观察到的HbA1c水平差异.
- 这些发现强调了需要探索除了药物坚持之外的其他因素,这些因素影响了西班牙裔种族和HbA1c水平在学术医疗中心之间的关系.
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