暴露于他类药物的选择和对他类药物的坚持之间的关联:观察性队列研究
Kathryn A Martinez1, Victor M Montori2, Fatima Rodriguez3
1Cleveland Clinic Center for Value-Based Care Research, Cleveland, OH, USA.
概括
临床医生使用电子健康记录工具Statin Choice显著增加了他类药物处方和遵守. 这种工具还导致低密度脂蛋白胆固醇水平在一年内降低.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 药理学 药理学是指药理学的学科.
背景情况:
- 类药物选择是一个共享决策工具,集成到电子健康记录中.
- 之前的研究表明,使用患者报告的数据,Statin Choice与他类药物坚持之间存在温和的关联.
研究的目的:
- 为了检查使用Statin Choice和他类药物处方,初级坚持 (处方填充) 和二次坚持 (12个月后使用他类药物) 之间的关联.
主要方法:
- 在克利夫兰诊所卫生系统进行了一项观察性队列研究.
- 包括17001名40至75岁的先前未服用他类药物的成年人,其10年ASCVD风险≥5%.
- 混合效应逻辑回归分析了基于Statin Choice使用的他类药物处方和坚持的几率.
主要成果:
- 那些接受了Statin Choice治疗的患者,被处方他类药物的几率高出9.04倍.
- 达他选择的使用与5.75倍更高的初级坚持率有关.
- 立方体选择使用与12个月后的LDL胆固醇降低12 mg/dL有关.
结论:
- 达丁类药物选择使用与增加的达丁类药物处方和填充密切相关.
- 该工具显示,与达丁类药物坚持治疗时间长达一年的相关性很弱.
- 建议进行随机试验以确认因果关系.
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