治疗持续性和处方口服,注射和吸入类皮质类固醇的变化:基于人口的药物使用研究
Eleni Domzaridou1, Matthew J Carr2,3, David M Williams4
1Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Pharmacoepidemiology and drug safety
|April 30, 2025
概括
一个小组的患者占大多数的皮质类固醇 (CS) 处方. 识别这些高处方个体是安全和经济有效的CS在初级保健使用的关键.
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:
- 皮质类固醇 (CS) 在初级保健中被广泛使用.
- 了解处方模式和治疗坚持对于优化患者的治疗结果和资源配置至关重要.
- 处方的变化可能会导致不理想的治疗和增加成本.
研究的目的:
- 在初级保健机构内分析口服,注射和吸入类皮质类固醇 (CS) 处方模式的变化.
- 调查使用不同形式的CS的患者之间的治疗持久性和覆盖率.
- 为了确定与更高的CS处方剂量相关的患者特征.
主要方法:
- 使用来自英语通用实践的患者级电子健康记录 (临床实践研究Datalink Aurum数据库).
- 从2000年1月到2021年6月,分析了一组新的CS用户.
- 采用洛伦茨曲线来规定偏斜度,卡普兰-梅尔图表用于治疗持久性,以及治疗覆盖率的覆盖患者比例 (PPC) 方法.
主要成果:
- 20%的口服和吸入CS使用者占总CS使用量的近80%.
- 患有并发症 (呼吸道,皮肤,炎症性肠道疾病) 的老年患者更有可能接受更高的CS剂量.
- 治疗持续时间分别为口服CS的20%和吸入CS的50%在1个月和2个月;6个月的覆盖率为口服CS的30%和吸入CS的60%.
结论:
- 存在显著的处方偏差,少数患者在初级保健中驾驶大多数口服和吸入CS使用.
- 识别具有高CS处方的患者对于有针对性的干预至关重要.
- 这种干预措施可以提高患者的安全性,并促进成本有效的皮质类固醇利用.
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