在初级心血管预防中,医生对老年人继续和停止使用他类药物的看法:一种定性方法研究
Andreas Marti1, Samuel Zbinden1,2, Laureline Brunner2
1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
BMJ open
|October 9, 2024
概括
由于证据有限,医生发现老年人服用他类药物的决定具有挑战性. 共享决策是关键,初级保健提供者发挥着至关重要的作用.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 关于老年人使用他类药物用于初级心血管预防的证据有限.
- 在这个人口群体中,医生对他类药物继续或停止服用的决策是复杂的.
研究的目的:
- 评估医生对在接受初级心血管预防的老年人中继续使用或停止使用他类药物的观点.
- 了解影响这些临床决策的挑战和因素.
主要方法:
- 使用四个重点小组进行定性描述性研究.
- 在瑞士与18名医生 (神经病学家,心脏病学家,内科医生,PCP) 的讨论中进行了感应和演的主题分析.
主要成果:
- 医生们很难区分老年人的初级预防与二级预防,他们认为缺乏证据是对他类药物决定的障碍.
- 他们注意到对反弹效应的恐惧和停止慢性药物的一般困难.
- 患者和医生之间的共同决策被认为是必不可少的,初级保健提供者 (PCP) 办公室被确定为这些讨论的理想环境.
结论:
- 在老年人中,继续和停止使用他类药物存在重大挑战,特别是当证据不清楚时.
- 初级保健提供者在导航这些决策方面至关重要,强调共享决策的重要性.
- 需要进一步的证据来支持对这些复杂情景的决策辅助工具的开发.
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