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过度活性膀治疗的趋势:临床护理途径,实践指南和治疗利用模式之间的关联
Hodan Mohamud1, Shada Sinclair2, Susanna Gunamany2
1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Neurourology and urodynamics
|November 19, 2024
概括
新的过度活性膀 (OAB) 准则与诊断增加,抗胆固醇药物的使用减少以及第三线疗法的更多采用有关,特别是在老年人中. 需要进一步的研究来证实长期影响.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 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:
- 过度活性膀 (OAB) 是一种普遍的慢性疾病,对健康和经济造成重大负担.
- 临床指南和护理途径旨在标准化OAB诊断和管理.
- 了解OAB治疗趋势对于优化患者护理至关重要.
研究的目的:
- 评估2014年AUA/SUFU指南修订和2016年临床护理途径出版之前和之后的OAB治疗利用趋势.
- 分析口服药物治疗和第三线程序治疗使用的变化.
- 为了确定OAB治疗模式和患者人口统计数据之间的关联.
主要方法:
- 使用国家行政索赔数据库 (2013-2018) 进行回顾性队列研究.
- 使用ICD代码识别了具有异常性OAB的成年患者.
- 分析使用CPT代码的口服OAB药物 (NDC代码) 和第三线疗法 (onabotulinumtoxinA,SNM,PTNS).
主要成果:
- 包括超过180万名患者;新的OAB诊断增加了369% (2013-2017).
- 口服药物处方在2016年达到峰值,到2018年下降了17%;米拉贝格朗的使用增加,特别是在65岁以上的患者中.
- 在2013年至2018年期间,第三线治疗程序几乎翻了一番.
结论:
- OAB的指导方针似乎影响了治疗模式,诊断增加和药物使用的转变.
- 观察到抗胆固醇使用的减少和β-3激动剂利用的增加,特别是在老年人中.
- 越来越多地采用第三线疗法表明指导方针的影响,需要进一步调查.
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