过度处方可能有害的药物:在英格兰的全科医院的一个观察性研究
Tasneem Khan1, Bethan Copsey2, Paul Carder3
1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK tasneemkhan@doctors.org.uk.
BJGP open
|January 22, 2024
概括
在英国的一般实践中,过度处方高风险药物与社会经济贫困有关,但这种关联因地区和药物类别而异. 地理位置起着关键作用,独立于社会经济地位.
科学领域:
- 一般实践和初级保健服务.
- 制药政策和处方的制定
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在英国的一般医疗中,对潜在有害药物的过度处方是一个复杂的问题,与社会经济贫困有关.
- 了解这些联系对于开发有针对性的干预措施和提高患者安全至关重要.
研究的目的:
- 分析五种高风险药物类别的一般实践处方趋势:阿片类药物,催眠药, gabapentinoids,NSAIDs和抗菌药.
- 调查不同英格兰地区这些药物的处方模式与社会经济贫困之间的关系.
主要方法:
- 一项利用一般实践的观察性研究,在三个不同的英格兰地区 (西约克郡,黑国,萨里和东萨塞克斯) 采用了2016-2021年的处方数据.
- 分析了阿片类药物,催眠药, gabapentinoids,NSAID 和抗菌药物的处方数据.
- 使用线性模型来评估处方趋势及其与多重贫困指数 (IMD) 和区域差异的关联.
主要成果:
- 观察到的显著趋势:NSAID,阿片类药物,催眠药和抗菌药的处方减少,加巴类药的处方每年增加.
- 多重剥夺指数 (IMD) 与大多数药物类别呈正相关性,除了抗菌药物 (当考虑年龄相互作用时).
- 区域差异很大;IMD与处方率之间的关联在不同地区之间显著不同,萨里和东萨塞克斯州与西约克郡相比,对几个药物类别的关联更强.
结论:
- 社会经济贫困与一般实践中高风险药物的过度处方之间的联系并不统一;它因地理区域和特定药物类型而异.
- 地理位置独立地影响处方率,这表明超出社会经济地位的因素有助于过度处方模式.
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