在加拿大行政卫生数据中验证用于识别非坚持药物不良事件的方法
Maeve E Wickham1,2, Kimberlyn M McGrail2, Michael R Law2
1Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
British journal of clinical pharmacology
|February 6, 2024
概括
使用索赔数据测量药物不服药是不准确的. 这些方法低估了问题,并错误地分类了坚持的患者,未能与临床诊断相比准确地识别不坚持.
科学领域:
- 药物监督 药物监督 药物监督
- 医疗保健服务研究 医疗服务研究
- 在医疗保健中的数据科学.
背景情况:
- 药物不服药是一种显著的不良药物事件,导致慢性疾病管理不良和医疗保健使用增加.
- 使用覆盖日数比例 (PDC) 或补充差距的行政数据是识别不遵守的常见方法.
- 这些管理方法与黄金标准的验证对于准确的患者识别至关重要.
研究的目的:
- 为了验证来自行政索赔数据的常见药物不服药措施.
- 为了比较PDC的准确性和药物补充差距方法与医院诊断的不依从.
主要方法:
- 来自不列颠哥伦比亚省三个潜在队列的976名患者 (2008-2015年) 的回顾性分析.
- 将前性识别的不良药物事件与药物索赔数据联系起来.
- 审查行政不遵守措施的敏感性和特异性.
主要成果:
- 不遵守措施的灵敏度较低,PDC为22.4%至37.5%,补充缺口为10.4%至58.3%.
- 7天的补充缺口是最敏感的,但不准确地归类为61.2%的非坚持者,而临床诊断为19.6%.
- 表现最好的PDC值 (95%) 仍然显示出有限的准确性.
结论:
- 与临床诊断相比,用于识别药物不服药的行政数据库方法缺乏准确性.
- 依靠这些方法可能会低估不遵守的真正流行率.
- 这些措施可能会将坚持的患者错误地归类为非坚持者,影响研究和临床实践.
更多相关视频
相关概念视频
Pharmacovigilance
833
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
833
Methods of Documentation VI: Case Management Model
573
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
573
Model-Independent Approaches for Pharmacokinetic Data: Noncompartmental Analysis
62
Noncompartmental analyses offer an alternative method for describing drug pharmacokinetics without relying on a specific compartmental model. In this approach, the drug's pharmacokinetics are assumed to be linear, with the terminal phase log-linear. This assumption allows for simplified analysis and interpretation of the drug's behavior in the body.
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This...
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This...
62
Documentation of Nursing Diagnosis
1.3K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.3K
Healthcare Associated Infections II: Preventive Measures
2.6K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.6K
Data Collection I
6.2K
Data collection gathers information needed to make accurate judgments about a patient's present condition. During a health history interview, subjective data is collected from the patient, their caregivers, or family members, and objective data is collected through observations and physical assessment. Patients are the primary source of subjective data. Thus information gathered from patients through interviews, observations, and physical examination is primary data. Secondary sources of...
6.2K


