医生报告的心脏衰竭药物的副作用管理的促进者和障碍
Sabrina Mangal1, Maryam Hyder2,3, John Mancini2
1Department of Biobehavioral Nursing and Health Informatics University of Washington School of Nursing Seattle WA USA.
Journal of the American Heart Association
|August 9, 2024
概括
医生在心力衰竭患者的药物副作用管理方面面临挑战. 识别,归因和对副作用采取行动对于有效的治疗和坚持治疗至关重要.
科学领域:
- 心脏病学 心脏病学
- 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:
- 医生的处方不足和患者的不遵守阻碍了指导方针导向的医学治疗.
- 对药物副作用的担忧对这些障碍有很大贡献.
- 关于医生管理药物副作用的策略的数据有限.
研究的目的:
- 在心力衰竭管理中识别诱导,归因和作用于药物副作用的促进者和障碍.
- 为未来的干预提供信息,旨在改善心力衰竭药物管理.
主要方法:
- 与管理心力衰竭药物的医生进行半结构面试.
- 对采访成绩单的内容分析,以确定主题.
- 专注于三个关键步骤:副作用诱导,归因和行动.
主要成果:
- 诱导障碍包括沟通不良;促进者包括指导问题和开放的沟通.
- 归因受到混因素和时间限制的阻碍;通过停止试验来促进.
- 风险与益处的评估和对危害的恐惧挑战了行动;患者沟通和试验结果促进了行动.
结论:
- 确定了管理药物副作用的关键促进因素和障碍.
- 这些发现为制定改善心力衰竭药物管理的策略提供了基础.
- 解决这些促进者和障碍物可以提高患者的坚持和治疗效益.
相关概念视频
Heart Failure Drugs: β-Blockers
326
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
326
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
406
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
406
Heart Failure Drugs: Diuretics
353
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...
353
Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
Heart Failure Drugs: Inotropic Agents
548
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
548
Barriers to Effective Communication II
3.6K
The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
3.6K


