测量多种药物的坚持使用指南导向医疗疗作为模型
Eli Reynolds1, Xiyue Li2, Amrita Mukhopadhyay2,3
1Department of Internal Medicine, New York University Langone Health.
medRxiv : the preprint server for health sciences
|December 18, 2025
概括
测量心力衰竭患者使用覆盖日数比例 (PDC) 的药物坚持率显示出广泛的变化. 选择的PDC方法对指导方针导向医疗疗 (GDMT) 的坚持评估和临床结果解释产生重大影响.
科学领域:
- 心脏病学 心脏病学
- 药物经济学 药物经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心力衰竭 (HF) 的管理需要复杂的药物治疗方案,称为指导方针导向医学疗法 (GDMT).
- 由于缺乏黄金标准,评估多种HF药物的坚持是具有挑战性的.
- 覆盖日数 (PDC) 的比例是药物坚持的常见指标.
研究的目的:
- 为了比较七种不同的覆盖日比例 (PDC) 措施,以评估心力衰竭 (HF) 患者对多种指南导向医疗疗 (GDMT) 药物的坚持.
- 评估这些各种PDC依从度和临床结果之间的关联.
主要方法:
- 一项回顾性队列研究包括34603名心力衰竭患者,他们在2021年4月至2022年7月期间填写了GDMT处方.
- 从电子健康记录和药房数据中得出了七项基于PDC的遵守措施.
- 临床结果包括急诊室的访问,住院和死亡.
主要成果:
- 在七个PDC措施中观察到广泛的遵守率,从最严格的 (每个) 措施的54%,到最不严格的 (至少一个) 措施的73%.
- 随着更多的GDMT药物,坚持的变化增加了.
- 在所有测量指标中,较高的PDC与更多的急诊室访问,住院和死亡有关.
结论:
- 选择覆盖日数比例 (PDC) 测量方法显著影响心力衰竭患者在指导方针导向医疗疗 (GDMT) 中对药物坚持的评估.
- 这种变化对政策,临床实践和干预策略有重大影响.
- 需要进一步的研究,以建立一个标准化和验证的方法来测量多种药物的坚持.
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