在马来西亚的初级保健环境中,在开始使用阿洛普醇之前实施HLA-B*58:01测试:从医生和患者的角度进行定性研究
Wei Leik Ng1, Norita Hussein1, Chirk Jenn Ng1,2,3
1Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
PloS one
|January 11, 2024
概括
在马来西亚的初级保健中实施HLA-B*58:01查Allopurinol诱导的严重皮肤不良反应 (SCAR) 是可行的. 首选针对高风险痛风患者进行有针对性的查,需要具有成本效益和明确的替代治疗途径.
科学领域:
- 药物基因组学 药物基因组学
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 艾洛普林醇是第一线痛风治疗,但可能导致严重的皮肤不良反应 (SCAR).
- HLA-B*58:01等位基因与氨醇诱导的SCAR密切相关,特别是在亚洲人群中.
- 建议在东南亚进行HLA-B*58:01查,但在马来西亚的初级保健中吸收率很低.
研究的目的:
- 探索初级保健医生和痛风患者对马来西亚实施HLA-B*58:01测试的看法.
- 评估在初级保健机构进行常规HLA-B*58:01查的可行性.
主要方法:
- 使用深入访谈和焦点小组讨论进行定性研究.
- 参与了来自不同医疗机构的18名痛风患者和18名初级保健医生.
- 用专题分析来分析编码数据.
主要成果:
- 在医生和患者中,HLA-B*58:01查的接受度很高.
- 由于担心患者拒绝服用,医生不充分披露aloopurinol的副作用;查可以改善这种情况.
- 障碍包括患者成本,成本效益,缺乏替代治疗方法,咨询负担和数据安全问题.
- 参与者更喜欢针对性查,而不是普遍查.
结论:
- 在马来西亚的初级保健中进行常规HLA-B*58:01测试可能是可行的.
- 实施需要对高风险群体实施具有成本效益的有针对性的查政策.
- 为阳性病例提供明确的替代治疗途径至关重要.
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