肺动脉高血压患者的药物不服药:肺动脉高血压协会注册 (PHAR)
Eric W Robbins1, Kaitlin Bradley2, David B Badesch3
1Brown University Warren Alpert Medical School, Department of Medicine, Providence, Rhode Island, United States.
Annals of the American Thoracic Society
|February 18, 2025
概括
肺动脉高血压 (PAH) 中的药物不服药率较低,但与医疗保健使用增加和生活质量降低有关. 预测因素包括男性性别和健康的社会决定因素,而不是治疗的复杂性.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 肺动脉高血压 (PAH) 具有显著的发病率和死亡率风险.
- 药物不服药是导致PAH不良结果的潜在因素,但其患病率和影响仍然不确定.
- 缺乏关于PAH药物不服药和以患者为中心的结果的多中心注册表研究.
研究的目的:
- 为了确定在肺高血压协会注册 (PHAR) 参与者中自我报告的不遵守的患病率,患有PAH或慢性血栓栓塞性肺高血压.
- 调查不遵守和以患者为中心的结果之间的关系,包括死亡率,住院率,急诊室访问和与健康有关的生活质量.
主要方法:
- 自我报告的不遵守数据是在PHAR的入学和后续访问中收集的.
- 用通用估计方程来建模与非坚持相关的预测因素和结果.
- 统计分析考虑了预测因子的二进制分布和结果的Poisson分布.
主要成果:
- 在1543名参与者中 (86.8%患有PAH),6.1%的人报告不遵守.
- 不遵守的预测因素包括男性性别,贫困,缺乏伙伴关系,公共/没有保险,以及不完整的大学教育.
- 不遵守相关性与50%更多的急救诊所访问,13.3%更多的住院,和61.9%更多的住院日.
- 没有发现不坚持和PAH治疗类型/数量或全因死亡率之间的关联.
- 不遵守与更糟糕的简单表格-12和EMPHASIS-10分数有关.
结论:
- 在PAH中自我报告的不坚持是相对较低的,但与男性性别和健康的社会决定因素有关.
- 虽然治疗的复杂性并不能预测不坚持,但它与增加医疗保健利用率和降低生活质量有关.
- 由于数据的局限性,前性研究有必要建立时间关系.
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