临床医生对高血压治疗的种族特定指南的看法
Chantal J Rabay1, Carolina Lopez1, Samantha Streuli2
1Department of Anthropology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Social science & medicine (1982)
|May 12, 2024
概括
当患者数据发生冲突时,临床医生不一致地应用了高血压治疗中的种族指南. 有证据表明,将种族从指导方针中删除可能会减少健康差异.
科学领域:
- 医学伦理与健康差异
- 临床实践指南 临床实践指南
- 药物基因组学与种族
背景情况:
- 种族在医学中经常被用作未测量的因素的代理,尽管缺乏生物基础.
- 高血压治疗指南,如JNC 8,包括种族特定的药物建议.
- 有有限的证据支持基于种族的药物反应的生理差异.
研究的目的:
- 检查临床医生在高血压治疗决策中如何优先考虑种族线索 (祖先,表型,自我识别).
- 调查当患者的种族数据与种族特定指南相冲突时,临床医生的决策.
- 评估种族特定指南对临床实践和潜在健康差异的影响.
主要方法:
- 与21名家庭或老年医学临床医生进行了深入采访.
- 临床医生观看了具有不一致的遗传祖先,表型和自我认同的种族的模拟患者视频.
- 分析临床医生如何在治疗决策中评估和优先考虑不同的种族线索和因素.
主要成果:
- 当患者的种族数据不一致时,临床医生不一致地应用了种族特定的高血压指南.
- 临床医生对种族的定义,种族因素的分类和优先级差异很大.
- 临床经验和其他因素影响了决策,以及关于遗传祖先整合的不确定性.
结论:
- 种族特异性高血压指南会影响治疗决策,但它们的临床理由需要重新评估.
- 不一致的应用凸显了在临床决策中使用种族的挑战.
- 从指南中删除种族可能会减轻在高血压管理中延续健康差异的风险.
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