诊所访问时间,处方模式和抗高血压药物坚持:来自美国链接电子健康记录和药房数据的证据
Han Zhang1, Menghan Gu1, Jun Soo Lee1
1Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
American journal of preventive medicine
|December 5, 2025
概括
晚些时候对高血压管理的诊所访问与降低药物坚持和处方填充有关. 优化预约安排可能会改善患者的治疗结果和药物管理的一致性.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 药物坚持对于管理高血压至关重要,但它往往是不理想的.
- 干预措施通常侧重于患者层面的障碍,忽视了常规护理因素,如诊所访问时间.
- 与急性护理不同,日间时间对慢性疾病管理的影响尚不清楚.
研究的目的:
- 调查一天中诊所访问的时间与抗高血压药物的服药之间的关联.
- 探索预约时间如何影响处方填充和其他临床决策.
主要方法:
- 一个纵向分析超过936,000美国成年人高血压和超过400万处方.
- 连接电子健康记录与药房发行数据 (2016-2024年).
- 预约时间和药物坚持 (覆盖日数比例≥80%) 和处方填充之间的估计关联,调整多个变量.
主要成果:
- 晚些时候的预约时间 (例如下午5点与早上7点) 与遵守和处方填充的几率明显较低有关.
- 每天晚一小时,坚持率降低1.0%,填充率降低0.9%.
- 晚些时候的访问与更短的持续时间,更少的日供应和更少的固定剂量组合处方相关,表明与过程相关的变化.
结论:
- 晚些时候的诊所访问时间与较差的药物坚持和处方填充率有关.
- 观察到的日间时间模式表明处方和发行流程的变化.
- 在整个诊所一天中标准化药物管理实践可以减轻这些差异.
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