老年人对抗高血压药物处方的偏好:一个离散选择实验
Edel O'Hagan1, Ann Livingstone2, Thomas Gadsden3
1Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia.
Journal of the American College of Cardiology
|March 4, 2026
概括
医生不太可能在患有较高风险的老年人中加强血压 (BP) 治疗,例如跌倒或虚弱. 数字健康工具可能有助于克服这种临床惯性.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
背景情况:
- 了解影响血压 (BP) 处方的因素对于管理老年人临床惯性至关重要.
- 确定影响治疗强化决策的关键属性可以为临床实践提供信息.
研究的目的:
- 调查医生的偏好和权衡,当加剧抗高血压治疗老年人 (≥65岁) 没有控制的血压.
- 分析患者特征和数字健康监测如何影响治疗决策.
主要方法:
- 对澳大利亚医生进行了一项离散选择实验,使用假设的患者个人资料.
- 根据年龄,虚弱,跌倒史,心血管风险和数字健康监测可用性,患者的个人资料各不相同.
- 混合多项逻辑和潜在类分析被用于评估属性效应和偏好异质性.
主要成果:
- 医生倾向于强化高血压目标,但随着患者年龄,跌倒和虚弱程度的增加,偏好下降.
- 较高的残留心血管风险降低了密集治疗的可能性,而数字健康的可用性增加了它.
- 两组医生出现了:风险耐受,数字参与 (64%) 和风险回避 (36%).
结论:
- 在老年人中,临床医生关于强化抗高血压治疗的决定受到患者年龄,跌倒,虚弱,感知益处和数字监测数据的显著影响.
- 数字健康干预措施在降低高血压的老年人中临床惯性方面表现有前途.
- 建议进行进一步的临床试验,以评估数字健康干预措施在这个人群中的有效性.
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