一般实践中可能不合适的药物的不合理变化:丹麦全国基于登记册的队列研究
Amanda Paust1,2, Claus Høstrup Vestergaard1, Ina Grønkjær Laugesen1,2
1Research Unit for General Practice, Aarhus, Denmark.
BMJ open
|February 4, 2026
概括
一般诊所的诊所在处方潜在不合适药物 (PIM) 中显示出显著的差异. 患者人口统计学,实践组织和位置影响PIM处方,突出需要改进患者安全策略.
科学领域:
- 一般的做法一般的做法
- 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
背景情况:
- 处方的不合理变化,特别是潜在不合适的药物 (PIM),会影响治疗质量.
- 了解导致处方变化的因素对于提高患者安全和优化医疗保健服务至关重要.
研究的目的:
- 调查一般医疗诊所特征 (人口组成,组织,地理) 与PIM处方不合理的变化之间的关联.
- 确定导致PIM处方不足和过度处方的具体因素.
主要方法:
- 丹麦一项基于登记的全国性队列研究,涉及1703家全科医院和超过430万名患者.
- 对每个诊所计算PIM倾向,定义为观察到与预期PIM发生率的比率.
- 分析通过低处方和过度处方来分层PIM倾向,以确定促成因素.
主要成果:
- 在最高和最低的处方诊所之间观察到13%的PIM倾向差异.
- 过度处方显示出50%的相对差异,而过少处方显示出12%的差异.
- 男性占主导地位和社会贫困的患者群体,单人实践,较小的患者名单,较短的组织寿命和增加的城市化与较高的PIM过度处方有关.
结论:
- 医疗治疗质量存在显著的不合理差异,主要是由PIM过度处方驱动的.
- 患者组成,实践组织和地理背景是治疗质量低下的关键决定因素.
- 需要新的策略来解决反向护理法,并提高一般实践中的患者安全.
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