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临床医生专业和HIV PrEP处方 撤销和放弃
Shivani Bakre1, Hsien-Yen Chang2, Jalpa A Doshi3,4
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
JAMA internal medicine
|August 19, 2024
概括
根据临床医师的专业,prep的坚持有所不同. 与初级保健医生相比,感染病专家处方暴露前预防 (PrEP) 患者的处方放弃几率较低. 其他专家的放弃率更高.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床医生在暴露前预防 (PrEP) 护理中发挥着至关重要的作用.
- 迄今为止,还没有任何先前的研究量化评估了跨临床医师专业的PrEP坚持差异.
研究的目的:
- 调查处方临床医生的专业与未开始或停止初始PrEP处方的患者之间的关联.
- 了解PrEP逆转率和戒断率如何因临床医生专业而异.
主要方法:
- 一项横截面研究利用了药房索赔数据 (2015-2019) 对接受新PrEP处方的18岁以上患者.
- 来自美国国家计划和提供者统计系统的处方者数据与索赔数据相匹配.
- 根据临床医生的专业,分析了逆转 (不取消最初的处方) 和放弃 (逆转加上在365天内不取消) 情况:初级保健医生 (PCP),传染病 (ID) 专家和其他专家.
主要成果:
- 该研究包括37003名患者,其中67%的患者从PCP获得处方,10%来自ID专家,24%来自其他专家.
- 逆转率为18% (PCP),18% (ID专家) 和25% (其他专家). 放弃率为12% (PCP),12% (ID专家) 和20% (其他专家).
- 经过调整后的分析表明,与PCP相比,ID专家的逆转几率降低了10%,放弃几率降低了12%. 其他专家有33%更高的逆转几率和54%更高的放弃几率.
结论:
- 初级保健医生是新的PrEP处方的关键入口,管理大多数患者.
- 临床医生专业对PrEP的坚持有很大影响,这可能是由于服务的患者人群不同.
- 未来的研究应该集中在改善PrEP坚持支持和教育的干预措施上,针对特定的临床医生群体量身定制.
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