以患者为导向的教育促进处方:非随机临床试验
Katie Fitzgerald Jones1,2, Kelly Stolzmann3, Jolie Wormwood4,5
1New England Geriatric Research Education and Clinical Center, VA Boston Health Care System, Jamaica Plain, Massachusetts.
JAMA internal medicine
|September 23, 2024
概括
预约前邮寄的患者教育材料增加了药物停止处方率. 这一战略有效地支持减少潜在的低益处或高风险药物.
科学领域:
- 老年学和老年医学是老年学和老年医学.
- 临床药房 临床药房
- 医疗保健服务研究 医疗服务研究
背景情况:
- 以患者为导向的教育材料是一个有前途的策略,可以增加药物处方.
- 关于这些材料在不同药物类别和不同风险感知中的影响的数据有限.
研究的目的:
- 评估以患者为导向的教育干预对临床医生对潜在的低益处 (质子抑制剂) 或高风险药物 (高剂量 gabapentin,糖尿病药物与低血糖风险) 的处方的影响.
主要方法:
- 一个务实,多站点,非随机的临床试验,涉及5071名患者在3个美国退伍军人事务医疗中心.
- 该干预措施涉及在初级保健预约前2-3周向患者发送药物特定的小册子.
- 为了进行比较,使用了一组历史的对照队列,这些队列在一年前被同一个初级保健医生 (PCP) 观察过.
主要成果:
- 与对照组 (25.8%) 相比,干预组显示出较高的抑郁率 (29.5%),这是统计学上显著的差异 (调整后的几率比:1.21;P=.008).
- 对于质子抑制剂,高剂量 gabapentin 和与低血糖风险相关的糖尿病药物,降低处方率增加.
- 干预的有效性在研究的药物组之间没有显著差异.
结论:
- 在初级保健预约前提供的以患者为导向的教育材料,可以有效地促进潜在的低益处和高风险药物的停止处方.
- 这种干预代表了一种可行的策略,以加强临床实践中的抑郁症努力.
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