慢性疾病中药物坚持和死亡率的系统审查:对临床指导方针和政策的影响
Jessica Hamuy Blanco1, Dina C Janse van Rensburg2,3, Audrey Jansen van Rensburg2,3
1Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
British journal of clinical pharmacology
|November 28, 2025
概括
在患有慢性疾病的成年人中,良好的药物坚持与较低的死亡风险有关. 然而,尽管有强有力的证据,南非的政策优先考虑监测,而不是基于遵守的预防策略.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生政策 卫生政策
背景情况:
- 药物坚持对于管理慢性疾病至关重要.
- 了解坚持和死亡率之间的联系对于公共卫生至关重要.
- 这个链接在南非政策中的表现需要调查.
研究的目的:
- 系统地审查有关药物坚持和慢性疾病成年人死亡风险之间的相关文献.
- 评估这种关联在南非卫生政策和立法中反映的程度.
主要方法:
- 在PubMed,MEDLINE和Scopus的系统文献搜索主要研究文章 (2004年以后,成年人18岁以上).
- 分析南非卫生立法和专业指导方针 (2014年以后) 使用一致的搜索术语.
- 效果指标的分类 (HR,IRR,OR) 按坚持水平 (好,中等,差,不坚持) 分类.
主要成果:
- 26篇文章证实,良好的坚持与较低的死亡风险有关 (大多数效果指标<1).
- 不良的坚持和不坚持显示出明显更高的死亡风险 (HR分别为1.63和2.77).
- 南非的政策文件包含的死亡率条款比遵守条款更多,同时发生率很低,这表明重点是监督遵守战略.
结论:
- 良好的药物坚持和降低死亡风险之间存在强烈的关联.
- 南非政策缺乏对预防死亡的药物坚持的战略重点.
- 基于坚持的风险评估应纳入临床和法律框架.
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