直接作用的口服抗凝剂和与FDA批准的非膜性心房的剂量潜在的不一致性:在美国九个医疗保健系统的回顾性现实世界分析
Bonnie DeLor1, Jon J Glover2, Timothy J Hartman2
1Pfizer Inc, 66 Hudson Blvd E, New York, NY, 10001, USA. bonnie.delor@pfizer.com.
Journal of general internal medicine
|October 18, 2024
概括
与FDA标签不一致的直接作用口服抗凝剂 (DOAC) 剂量在非膜动 (NVAF) 患者中很常见. 不一致的剂量因患者因素,处方者和医疗保健系统而异,突出显示需要改善监测.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
- 心脏病学 心脏病学
背景情况:
- 直接作用的口服抗凝剂 (DOAC) 对于预防非膜动 (NVAF) 的中风和栓塞至关重要.
- 然而,偏离FDA批准的DOAC剂量指南是常见的,并且与患者不良结果有关.
研究的目的:
- 为了确定在门诊NVAF患者中标签不一致的DOAC剂量的患病率.
- 为了确定与低于或高于推的DOAC剂量相关的患者特异变量.
主要方法:
- 对来自美国九个医疗保健系统的电子健康记录进行了回顾性分析.
- 分析了2022年接受DOAC治疗的成年NVAF患者的数据.
- 多变量回归确定了与标签不一致的DOAC剂量相关的因素.
主要成果:
- 在51,128名NVAF患者中,近10%接受了标签不一致的DOAC剂量 (6.8%较低,3.0%更高).
- 老年,功能障碍,高血压,女性性别和体重增加等因素与不一致的剂量有关.
- 剂量不一致性因处方者专业和医疗保健系统而异.
结论:
- 在NVAF患者中,DOAC剂量不一致性受到患者人口统计学,临床状态,处方者类型和医疗保健环境的影响.
- 需要有针对性的干预措施来确保适当的DOAC剂量,特别是在脆弱的患者群体.
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