在维持血液透析和腹膜透析的患者中,处方模式和药物费用
Anukul Ghimire1, Anita M Lloyd2, Aminu K Bello2
1Department of Medicine, University of Calgary, Calgary, AB, Canada.
概括
与普通人群相比,透析患者的药物使用和费用显著更高. 这凸显了在透析护理中关闭处方策略的关键需求.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床药房 临床药房
- 卫生经济学 卫生经济学
背景情况:
- 多药制对于接受透析的患者来说是一个重大的临床挑战.
- 之前的研究还没有充分解决多药在这个群体中的流行率和经济影响.
研究的目的:
- 在接受血液透析 (HD) 或腹腔透析 (PD) 患者的基于人口的队列中调查多药的流行率和相关成本.
主要方法:
- 研究了一组20岁及以上的成年人,他们在加拿大阿尔伯塔省接受维护性HD或PD,截至2019年3月31日.
- 药物使用的特点是药物类别和潜在不适合老年人的药物 (PIM).
- 计算了每日药片负担,年度总成本和每名参与者的年度成本,并与年龄和性别匹配的一般人口队列进行了比较.
主要成果:
- 该研究包括2248名透析患者 (平均年龄63岁). 药物类别的中位数为6,平均每日药物负担为8.0.
- 12%的患者接受了在衰竭中禁忌的药物. 每位参与者的年平均成本为3831.1美元.
- 与普通人群相比,透析患者的药物负担是3倍以上,费用是10倍以上. 血液透析患者的成本比腹膜透析患者的成本更高.
结论:
- 透析患者的处方药使用和相关的医疗保健费用比普通人群高得多.
- 显然,迫切需要开发和实施针对透析患者群体量身定制的有效的脱处方干预措施.
相关概念视频
01:27Dialysis
288
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
288
01:11Renal Failure: Dose Adjustments
79
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
79
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.0K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.0K
01:22Heart Failure Drugs: Diuretics
362
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
362
01:17Factors Affecting Renal Clearance: Renal Impairment
74
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
74
01:15Drug Dosage Regimen: Overview
3.5K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.5K