从1996年到2023年的荷尔蒙替代疗法吸收和停止趋势:威尔士人口的观察研究
Robin Andrews1,2, Arron Lacey3, Kate Bache2
1School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
概括
威尔士的激素替代疗法 (HRT) 处方显示了2021年后转向通过皮肤使用的转变,口服HRT下降. 坚持根据年龄和HRT类型而异,社会经济贫困仍然是进入障碍的障碍.
科学领域:
- 生殖医学 生殖医学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 激素替代疗法 (HRT) 是对更年期症状的常见治疗方法.
- 处方模式和对HRT的坚持可能受到各种因素的影响,包括施用途径,患者人口统计数据和公众对安全性的看法.
- 了解停药的长期趋势和预测因素对于优化HRT使用至关重要.
研究的目的:
- 分析1996年至2023年在威尔士的HRT处方趋势 (口服和透皮).
- 在开始后一年内确定HRT停止的预测因素.
- 检查社会经济因素和时间趋势对HRT准入和遵守的影响.
主要方法:
- 使用安全匿名信息链接 (SAIL) 数据库进行的观察性研究,包括威尔士的初级和中等保健数据.
- 分析每年每1000名女性的HRT处方率,按HRT类型,年龄和剥夺五分位数分层.
- 用于评估40-65岁女性中断药物的预测因素的零膨胀负二项式回归.
主要成果:
- 透皮HRT处方在2021年后呈指数级增长,而口服HRT处方在2002年后下降.
- 戒断率呈现出曲线趋势,年轻和老年人群的比例较高,40年代中期至50年代初的比例较低.
- 口服HRT与更低的断药率相关,通过皮肤治疗与更高的断药率相关. 社会经济贫困与减少HRT处方有关.
结论:
- 人体健康治疗的处方差异反映了对安全的看法和媒体报道的影响的变化.
- 坚持受HRT给药路线和症状缓解的影响,在40年代中期至50年代初的女性中观察到更好的坚持.
- 社会经济贫困是获得HRT的重要障碍,需要针对性策略来实现公平的处方.
相关概念视频
01:40Hormonal Regulation
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
01:33Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
02:20Longitudinal Research
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
01:22Target Cell Response to Hormones
Hormones intricately bind to receptors on the surface or within target cells, initiating a cascade of cellular responses.
Notably, the cellular response can be regulated by altering the number of receptors expressed in the cell. For example, prolonged exposure to elevated hormone levels results in a gradual decline or down-regulation in the number of receptors for that specific hormone on the cell surface. Conversely, in response to low hormone levels, cells may use up-regulation, producing an...
Notably, the cellular response can be regulated by altering the number of receptors expressed in the cell. For example, prolonged exposure to elevated hormone levels results in a gradual decline or down-regulation in the number of receptors for that specific hormone on the cell surface. Conversely, in response to low hormone levels, cells may use up-regulation, producing an...
01:29Therapeutic Drug Monitoring: Affecting Factors
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...