在加拿大引入儿科高血压指南后,实践模式的时间趋势
Michael Wu1, Allison Dart2, Leanne Kosowan3
1Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada.
JAMA network open
|February 8, 2024
概括
新的儿科高血压指南增加了加拿大的血压查和诊断率. 然而,对高血压的随访护理仍然不够理想,这表明需要更好地遵守指南.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 公共卫生 公共卫生
- 临床实践指南 临床实践指南
背景情况:
- 新的加拿大和美国儿科高血压指南于2016年和2017年发表.
- 这些指导方针对初级保健实践模式的影响尚不清楚.
研究的目的:
- 确定儿科高血压 (HTN) 准则是否与初级保健实践的变化有关.
- 评估指南实施与临床实践模式变化之间的关联.
主要方法:
- 在加拿大7个省份进行了回顾性,基于人口的队列研究.
- 利用了2011-2019年的电子医疗记录数据,分析了343,191名儿童和青少年.
- 间断时间序列分析评估了指导方针实施前后的结果.
主要成果:
- 在指南实施后,血压 (BP) 查和HTN患病率显著增加.
- 在6个月和1年后,高BP的随访趋势显著下降.
- 实验室检测率没有显著变化;观察到药物处方率下降.
结论:
- 儿科高血压指南导致加拿大初级保健中增加了血压查和HTN检测.
- 高血压的非最佳后续行动突出了遵守指南的差距.
- 儿科HTN率的上升需要更好地遵守指导方针,以获得更好的患者结果.
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