在荷兰的心血管风险管理计划中,患者特征和停止治疗的原因
Geert H J M Smits1,2, Sander van Doorn3, Michiel L Bots3
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. g.smits@pozob.nl.
BMC primary care
|February 11, 2024
概括
终止心血管风险管理 (CVRM) 计划的患者年龄更小,并患上较少的并发病,并且不太可能患有先前心血管疾病 (CVD). 了解这些原因有助于个性化护理,以减少CVRM计划中断.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健管理的管理
背景情况:
- 自2010年以来,荷兰的护士领导的综合心血管风险管理 (CVRM) 计划的参与越来越多.
- 评估CVRM计划的有效性需要了解患者停止治疗的模式和原因.
- 识别与患者退学相关的因素对于优化CVRM护理提供至关重要.
研究的目的:
- 确定患者从护士领导的综合CVRM计划中停药的主要原因.
- 为了比较没有特定原因停止治疗的患者与完成8年护理的患者的特征.
- 为减少CVRM计划消耗的战略提供信息.
主要方法:
- 2010年4月1日至2018年4月1日期间注册的3997名患者电子健康记录的手动审查.
- 停药原因的分类,包括死亡和转移到糖尿病护理.
- 对患者人口统计学和临床因素的比较分析,对于那些停止治疗的人与那些留在计划中的患者.
主要成果:
- 29.8%的参与者停止了CVRM计划;6.8%的死亡,4.9%转移到糖尿病护理.
- 18.1%的人在没有特定原因或应要求的情况下停止服用,其中9.3%的人之前有心血管事件.
- 没有特定原因停止治疗的患者年轻,心血管并发症较少,心血管疾病事件较少,与完成8年护理的患者相比,更经常吸烟.
结论:
- 年龄较小,没有先前的心血管疾病,心血管并发症较少,以及更好的药物坚持是患者在没有特定原因的情况下停止CVRM计划的特征.
- 探索患者特定的停药原因是开发个性化方法预防停药的关键.
- 结果可以指导干预措施,以改善CVRM计划的保留和长期患者的结果.
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