在一个多中心的美国初级保健队列中的青素过敏脱标中的种族差异
Kimberly G Blumenthal1, Valerie E Stone2, Bohang Jiang3
1Division of Pulmonary, Allergy, and Sleep Medicine, Mayo Clinic, Jacksonville, Florida; Harvard Medical School, Boston, Massachusetts; The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts.
概括
青素过敏脱标在黑人和亚洲患者中不太常见,种族差异因医疗保健系统而异. 解决障碍对于公平的抗生素管理和减少抗菌素耐药性至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 传染性疾病 传染性疾病
- 健康 公平 卫生 公平
背景情况:
- 青素过敏标签影响10%的人,但往往不表明真正的IgE介导过敏.
- 不准确的青素过敏标签增加了广谱抗生素的使用,导致治疗失败和抗菌素耐药性.
- 对青素过敏的取消标签是一种基于证据的策略,旨在改善对抗生素的获取和打击抗药性.
研究的目的:
- 调查患者种族与青素过敏患病率之间的关联.
- 为了确定在青素过敏脱标的种族差异潜在的调解因素.
主要方法:
- 两种卫生系统的初级保健患者的回顾性队列研究 (2019年1月-2022年4月).
- 对青素过敏的取消标签是主要结果,定义为没有活跃的过敏记录.
- 自我报告的种族是主要的暴露,分析对年龄,性别,语言偏好,并发症和医疗保健利用进行了调整.
主要成果:
- 黑人患者的青素过敏脱标的几率较低 (aOR 0.73).
- 亚洲患者也表现出较低的脱标流行率 (aOR 0.76),非英语语言偏好和医疗保健利用作为重要调解因素.
- 在取消标签的种族差异在两个医疗保健系统的流行率和调解率上有所不同.
结论:
- 青素过敏脱标存在显著的种族差异,特别是在黑人和亚洲患者身上.
- 医疗保健系统之间的不一致性凸显了对临床,机构和结构障碍的进一步调查的需要.
- 推进公平的取消标签实践对于有效的抗生素管理和减轻抗菌素耐药性至关重要.
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