尿失禁药物:在初级保健中患者发起的担忧
Joan Neuner1, Emily Schmitt2, Aaron Winn3
1From the Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Urogynecology (Philadelphia, Pa.)
|July 2, 2024
概括
患者对过度活动的膀 (OAB) 和急性尿失禁 (UUI) 药物的担忧在初级保健中很常见. 这些问题,包括成本和副作用,往往在办公室访问之外出现,并且因药物类型而异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过度活性膀 (OAB) 和冲动性尿失禁 (UUI) 是影响生活质量的普遍情况.
- 准则推的药物提供有效性,但与重大成本和潜在的副作用有关.
- 在初级保健机构中,患者对OAB/UUI药疗的看法仍未得到充分研究.
研究的目的:
- 描述关于OAB/UUI药物的初级保健提供者 (PCP) - 患者相互作用.
- 确定所讨论的临床问题类型,成本和授权问题.
- 检查这些讨论的沟通方式.
主要方法:
- 在18-89岁的妇女中进行的回顾性队列研究,在2017-2018年间处方OAB/UUI药物.
- 在15个月内,对事先授权请求和患者报告的担忧 (成本,副作用,无效性) 进行电子健康记录审查.
- 后勤回归分析以评估患者人口统计,并发症,药物类别和报告的担忧之间的关联.
主要成果:
- 46.2%的患者报告至少有一种OAB/UUI药物问题,许多患者报告在办公室外访问.
- 较高的并发病率与任何担忧的可能性较低有关.
- 与短效抗类药物相比,服用长效抗类药物 (非oxybutynin) 的患者对副作用的担忧较少,但对成本的担忧更多.
结论:
- 患者对OAB/UUI药物的担忧在初级保健中很常见,并且经常出现在预定的预约之外.
- 患者关注的性质 (例如,成本与副作用) 是受处方的特定药物类别的影响.
- 了解这些不同的问题对于优化OAB/UUI药物治疗在初级保健中至关重要.
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