访问频率,护理连续性和药房填充在心力衰竭患者的坚持之间的关联
Carine E Hamo1, Amrita Mukhopadhyay2, Xiyue Li3
1Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY.
American heart journal
|April 15, 2024
概括
减少喷射率心力衰竭 (HFrEF) 的更长时间治疗并没有改善药物坚持,但与住院治疗的减少有关. 较低的护理连续性增加了所有原因和心力衰竭住院的风险.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 以指导方针为导向的医学疗法 (GDMT) 对心力衰竭与减少喷射率 (HFrEF) 至关重要.
- 在患者遵守GDMT方面仍然存在重大挑战.
- 护理的连续性可能会影响HFrEF患者的坚持和减少住院治疗.
研究的目的:
- 在HFrEF中调查护理连续性和药物坚持GDMT之间的关联.
- 检查HFrEF患者的护理连续性和全因和心力衰竭住院治疗之间的关系.
主要方法:
- 在2017-2021年期间,对3971名患有HFrEF (EF ≤40%) 的成年人进行了横截面研究.
- 使用Bice-Boxerman护理连续性指数 (COC) 和通常护理提供者指数 (UPC) 测量护理的连续性.
- 主要结局:GDMT坚持 (覆盖日数比例≥80%);次要结局:所有原因和HF住院1年.
主要成果:
- 护理的连续性与HFrEF患者的GDMT坚持没有显著的关联.
- 较高的COC (第三四分位数) 与最高四分位数 (OR 1.26,P = .024) 相比,与更好的GDMT坚持有关.
- 较低的护理连续性 (最低的UPC和COC数量) 与所有原因和HF住院的几率增加有关.
结论:
- 在HFrEF中,护理连续性与GDMT遵守没有显著的关联.
- 在HFrEF患者中,较低的护理连续性与所有原因和心力衰竭住院的风险更高有关.
- 改善护理连续性的策略可能对减少HFrEF住院治疗很重要.
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