慢性阻塞性肺病患者中长期接受催眠的发生率和预测因素
Jason M Castaneda1, Aristotle Leonhard2, Laura J Spece3,4
1University of Washington, Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Washington, United States; jasonc9@uw.edu.
Annals of the American Thoracic Society
|February 12, 2025
概括
慢性阻塞性肺病 (COPD) 患者长期使用催眠药物很常见,尽管有指导方针. 呼吸系统症状和心理健康问题可能导致这种做法.
科学领域:
- 肺部医学 肺部医学
- 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:
- 患有慢性阻塞性肺病 (COPD) 的患者经常接受治疗失眠的催眠处方.
- 临床指南建议短期使用催眠药,但长期处方在COPD患者中很常见.
- 由于COPD的潜在不良影响,了解长期使用催眠的发生率和预测因素至关重要.
研究的目的:
- 确定COPD患者长期使用催眠药物的发生率.
- 为了确定与COPD中与指导方针不一致的长期催眠处方相关的患者和现场水平的因素.
主要方法:
- 分析了2010-2019年全国退伍军人健康管理局的数据.
- 确定了新开始接受催眠药 (zolpidem,美拉,特拉佐,doxepin) 的COPD患者.
- 长期使用被定义为在随后的90天内持续使用催眠药30天以上.
- 混合效应物流回归评估了长期催眠接收的预测因素.
主要成果:
- 超过一半 (55.6%) 的COPD患者新处方的催眠药长期服用.
- 长期使用与短效β-激动剂,维持性吸入剂和心理健康诊断 (PTSD,抑郁症,焦虑症) 的使用增加有关.
- 频繁的初级保健访问预测了长期的催眠使用,而初始的黑激素使用和肺部访问是保护性的.
结论:
- 长期的催眠处方在COPD患者中很普遍,违反了临床指南.
- 呼吸系统症状负担和精神健康并发症等因素似乎影响了长期的催眠处方.
- 未来的干预措施应解决这些并发症,以减少COPD中不适当的长期催眠使用.
更多相关视频
相关概念视频
01:22Chronic Obstructive Pulmonary Disease
1.1K
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
1.1K
01:29Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K
01:26COPD: Management Using Bronchodilators and Corticosteroids
174
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
174
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
2.7K
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
2.7K
01:19Respiratory Assessment: Purpose and Indications
1.0K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.0K