丹麦心力衰竭患者处方差异:一项全国纵向队列研究
Maria Klitgaard Christensen1,2, Vibe Bolvig Hyldgård3,4, Christian Madelaire2
1Department of Clinical Research, University of Southern Denmark, Odense, Denmark mklitgaard@health.sdu.dk.
Heart (British Cardiac Society)
|May 10, 2025
概括
在处方救命性心力衰竭药物,血管激素受体-尼普利辛抑制剂 (ARNi) 和-葡萄糖共同载体2抑制剂 (SGLT2i) 方面存在差异. 妇女,老年患者,独自生活或非本土血统的人不太可能接受这些关键的治疗.
科学领域:
- 心脏病学 心脏病学
- 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:
- 建议使用 ангиотензин受体-neprilysin 抑制剂 (ARNi) 和-葡萄糖共载体 2 抑制剂 (SGLT2i) 治疗心力衰竭.
- 这些药物改善症状,减少再入院,降低心力衰竭患者的死亡率.
研究的目的:
- 调查ARNi和SGLT2i处方中的人口,地理和社会经济差异.
- 在通用医疗保健系统中分析处方模式.
主要方法:
- 利用国家登记册来识别丹麦心力衰竭患者,这些患者在指南更新后被诊断出心力衰竭.
- 使用阿伦-约翰森估计器和考克斯比例危险模型分析ARNi (n=43,625) 和SGLT2i (n=2819) 处方.
- 在2022年6月30日之前跟踪患者,直到处方赎回,移民,死亡或审查.
主要成果:
- 缺乏ARNi和SGLT2i处方与女性,年龄较大,单身生活和非丹麦本土背景有关.
- 危险比率表明这些群体的处方率明显较低.
- 在与教育和收入相关的ARNi处方中观察到一个统计学上显著的社会梯度.
结论:
- 对于心力衰竭的ARNi和SGLT2i的处方存在显著差异.
- 教育水平较低,收入较低以及特定的人口因素与这些重要药物的处方不足有关.
- 解决这些差异对于公平的心力衰竭护理至关重要.
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