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Published on: June 21, 2018
在初级保健中同时开始服用两种或两种以上的药物:有多频繁,有多频繁需要?
Tewodros Eguale1,2, Maria Mirica2, Alejandra Salazar2
1Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
Journal of general internal medicine
|March 28, 2025
概括
初级保健医生经常同时开始多种新药,经常没有强有力的证据. 这种做法在医生和医疗机构之间有很大差异,这表明了潜在的安全改进机会.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 主要护理医学 医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 越来越多地强调保守的处方原则.
- 初级保健医生对初级保健医生 (PCP) 同时启动新药的理解有限.
- 需要确定何时同时开始多种药物是必要的.
研究的目的:
- 量化PCP同时启动多个新处方的频率.
- 评估证据支持需要同时启动多种药物的必要性.
- 描述PCP和临床场所之间并发处方实践的变化.
主要方法:
- 追溯队列研究的设计.
- 分析四个临床场所PCP撰写的处方.
- 从2017年1月到2018年12月收集的数据.
主要成果:
- 分析了近50万份处方,同时新药开始在不同地点 (14.0%至27.2%) 有显著差异.
- 在每个地点处方多种新药时,医生之间存在广泛的变化.
- 最少的同时处方 (0.6%) 得到了强有力的证据支持;大多数缺乏同时启动证据或带来潜在风险.
结论:
- PCP经常同时启动多种新药,通常没有强有力的证据.
- 在各个医生和机构之间,处方实践存在显著差异.
- 研究结果表明,通过解决并发药物开始模式,有机会提高处方安全性.
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