基于人群的质子抑制剂减记策略:病例控制研究的健康结果
Amaya Echeverría Gorriti1, Javier Gorricho Mendívil2, Janire Etxegia Apezetxea3
1Servicio Navarro de Salud-Osasunbidea, Subdirección de Farmacia y Prestaciones, Pamplona, España; Instituto de Investigación Sanitaria de Navarra (IdiSNA, Pamplona, España.
概括
对没有胃肠道出血风险因素的患者来说,停止处方质子抑制剂 (PPI) 是安全的,减少了死亡率和住院病例. 这一策略还降低了微量营养素缺乏,骨折和肺炎的风险.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
- 公共卫生 公共卫生
背景情况:
- 在缺乏临床适应症的患者中,实施了基于人群的策略,以减少对质子抑制剂 (PPI) 的处方.
- 这项研究调查了PPI停止处方与持续使用PPI的安全性和不良影响.
研究的目的:
- 评估与PPI脱相关的健康结果.
- 评估在没有胃肠道出血风险因素的患者中中止PPI的安全性.
主要方法:
- 在队列设计中使用了一个嵌套的病例控制研究.
- 主要终点:死亡率或紧急入院的综合结果.
- 二级终点包括通过过程挖掘分析的各种不良事件和患者轨迹.
主要成果:
- 发现PPI减记是安全的,显示死亡率和住院率降低 (OR=0.78).
- 胃部不良事件的发病率较高,但没有胃肠道出血.
- 降低处方导致微量营养素缺乏,骨折和肺炎的发生率降低.
结论:
- 对于没有胃肠道出血风险因素的患者来说,PPI减记是一种安全的策略.
- 该策略与死亡率和住院患者的良好结果有关.
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