患者对抗凝血治疗的偏好:对离散选择实验的审查
Ilja M Brugman1,2, Linda van Eikenhorst3, Caroline Schlinkert3
1Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. i.brugman@nivel.nl.
The patient
|November 28, 2025
概括
患者在选择抗凝药时优先考虑安全性和有效性,而不是方便性. 个人偏好因人口统计,健康状况和先前经验而异,需要量身定制的医疗保健方法.
科学领域:
- 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
- 以患者为中心的护理
背景情况:
- 患者参与对于改善抗凝血药物的安全性和有效性至关重要.
- 了解患者对抗凝血剂的决策因素有助于医疗保健专业人员.
- 离散选择实验 (DCE) 对于探索患者在药物选择中的偏好是有价值的.
研究的目的:
- 对患者对抗凝血药物考虑和偏好的离散选择实验 (DCE) 进行审查.
- 确定影响患者长期抗凝药治疗选择的因素.
- 为医疗保健专业人员提供有关加强患者参与抗凝剂管理的信息.
主要方法:
- 使用PubMed和Web of Science核心集合对离散选择实验 (DCE) 的系统审查.
- 搜索于2025年7月更新,包括长期使用抗凝剂 (DOAC,VKA,抗血小板,LMWH) 的研究.
- 研究选择和质量评估遵循了PRISMA 2020指南,包括13篇纳入的文章.
主要成果:
- 患者主要优先考虑抗凝剂的安全性和有效性,而不是方便性.
- 服用频率是影响选择的最重要的便利因素.
- 患者的偏好是异质的,受到地理,人口,社会经济因素,健康状况和先前经验的影响.
结论:
- 医疗保健专业人员可以通过认识到患者的不同偏好来改善抗凝剂护理.
- 根据个体患者的需要量身定制抗凝剂治疗可以提高安全性和疗效.
- 认可患者因素是成功长期抗凝剂管理的关键.
相关概念视频
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:15Bioequivalence Experimental Study Designs: Repeated Measures, Cross-Over, Carry-Over, and Latin Square Designs
Bioequivalence experimental study designs play a pivotal role in testing the effectiveness of various treatments. Key among these are the repeated measures, cross-over, carry-over, and Latin square designs. In the repeated measures design, each subject receives all treatments, allowing for temporal comparisons. This type of design is useful in reducing variability but requires careful planning to avoid bias.The cross-over design, an economical method, involves sequential administration of...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...