门诊患者初级和二级心血管预防服务中的处方适当性
Davide Ceruti1, Chiara Tognola1, Michela Algeri2
1School of Medicine and surgery, University of Milano-Bicocca, Piazza dell'ateneo nuovo 1, 20126, Milan, Italy.
概括
许多非侵入性心脏诊断测试被不适当地规定,特别是用于高血压的初级预防. 提高对指导方针的遵守程度可以减少医疗保健的浪费,并优化患者的护理.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 预防医学 预防医学
背景情况:
- 过度使用诊断程序可能导致医疗保健浪费,特别是在管理常见的疾病,如动脉高血压.
- 缺乏具体的适当性准则有助于增加不必要测试的风险.
研究的目的:
- 评估在门诊服务中处方非侵入性诊断测试的适当性,以进行初级和二级预防.
- 评估了心声回声,带超声波,心电图运动测试和24小时门诊血压监测 (ABPM).
主要方法:
- 对559次门诊病人的回顾性分析.
- 与意大利和欧洲综合指南相比,对处方进行了评估.
主要成果:
- 总体而言,适当的处方率为40.3%.
- 24小时的ABPM显示出最高的适当性 (49.4%),其次是心声回声 (43.9%).
- 与初级预防 (35.3%) 相比,二次预防 (61.6%) 的适当性显著更高.
结论:
- 很大一部分非侵入性心脏病检查的处方不恰当,特别是在初级预防机构.
- 调查结果突出了改善准则遵守的必要性,以优化诊断测试利用率.
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