在美国军人中轻度创伤性脑损伤后,佐地亚平的处方模式
Lauren Earyes1,2, Yll Agimi1,2, Katharine Stout1
1Traumatic Brain Injury Center of Excellence, Defense Health Agency, Silver Spring, MD 20910, USA.
Military medicine
|July 19, 2024
概括
提供者正在为轻度创伤性脑损伤 (mTBI) 的服务人员开处方类药物 (BZD),尽管指南建议不要这样做. 这项研究检查了mTBI患者的BZD处方模式,以了解实践中的差距.
科学领域:
- 神经科学是一个神经科学.
- 临床药理学 临床药理学
- 军事卫生系统研究 军事卫生系统研究
背景情况:
- 临床实践指南 (CPG) 旨在标准化对创伤性脑损伤 (TBI) 等疾病的护理.
- CPGs对提供商实践的影响,特别是对TBI的影响,仍未得到充分研究.
- 由于对愈合和认知功能的潜在负面影响,不建议使用二 (BZD) 在TBI后.
研究的目的:
- 评估将临床实践指南转化为实际临床实践,对美国服务人员诊断出轻度创伤性脑损伤 (mTBI) 的二胺 (BZD) 处方进行评估.
- 分析mTBI患者中BZD的处方模式,包括剂量,类型,提供者,设置和初级诊断.
主要方法:
- 使用了来自军事卫生系统医疗数据库 (MDR) 的数据,包括全面的门诊/专业遭遇记录 (CAPER) 和药房详细交易服务 (PDTS).
- 在2015年10月1日至2016年9月30日期间,确定了美国服务人员首次mTBI诊断.
- 通过对队列子集的电子健康记录进行结构化审查,验证了处方数据.
主要成果:
- 美国4.5%的mTBI服务人员在积极治疗期间接受了BZD处方.
- 与没有服用BZD的军人相比,处方BZD的军人更有可能是女性和老年人.
- 与抗抑郁药,NSAIDs和阿片类药物同时处方BZD在mTBI患者中很常见.
结论:
- 尽管临床实践指南建议不要在急性mTBI中使用BZD,但仍在发布处方.
- 混因素可能会影响对mTBI患者的处方决定.
- 需要进一步的研究,以了解医疗服务提供者如何接受和利用临床实践指南,以弥合建议和实际实践之间的差距.
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