需要参与中风预防与老年人心房动和多重疾病的共享决策
Hawa O Abu1, Jane S Saczynski2, Michelle Nabi3
1Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01605, USA.
Advances in geriatric medicine and research
|December 19, 2025
概括
许多患有心房动 (AF) 和多种健康状况的老年人希望更多地参与共享决策 (SDM) 以预防中风. 年龄较小,女性性别和少数群体地位与这种需求有关.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心房动 (AF) 在老年人群中很常见,通常与多种慢性疾病 (多重病变) 一起发生.
- 在这种人群中,中风预防通常涉及口服抗凝剂,需要共享决策 (SDM).
- 了解患者对SDM的偏好对于有效的护理至关重要.
研究的目的:
- 确定患有AF和多病症的老年人患病率,他们希望更多地参与SDM预防中风.
- 识别患者的特征与这种渴望更大的SDM参与相关.
主要方法:
- 一项前性队列研究包括532名65岁以上的AF患者和至少一个慢性疾病.
- 一年后的跟进评估了SDM在抗凝剂启动和选择方面的偏好.
- 多变量后勤回归确定了与更大的SDM参与偏好相关的因素.
主要成果:
- 大约三分之一的参与者表示希望在抗凝血决策中更多的SDM.
- 年轻的参与者 (65-74岁),女性,非白人,受教育程度较低,感知负担较高或并发症较少的人更有可能想要更多的SDM.
- 多重病症的患病率有所不同,其中41%患有1 - 4,40%患有5 - 7,19%患有8个以上的慢性疾病.
结论:
- 临床医生必须承认AF和多病症的老年患者在中风预防中提高SDM的表达需求.
- 需要量身定制的干预措施来改善共享决策,并优化对这一人口群体的中风预防策略.
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