Pont Lisa G, Sturkenboom Miriam C, van Gilst Wiek H, Denig Petra, Haaijer-Ruskamp Flora M
Drug Utilisation Studies, Department of Clinical Pharmacology, University of Groningen, The Netherlands.
Pharmacoepidemiol Drug Saf. 2003 Jun;12(4):327-34. doi: 10.1002/pds.809.
The aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5-year period (1996-2000).
This study consisted of repeated cross-sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care database. The cohort comprised all patients aged > or = 55 years with a CHF diagnosis and prescribed a cardiovascular medication during the study period. The point prevalence per calendar year was determined for each of the main drug groups used to treat CHF.
The study population consisted of 3121 CHF patients. Small increases were seen in the percentage of CHF patients prescribed spironolactone (4.6%, 95% CI: 2.3-6.9%), beta-blockers (6.1%, 95% CI: 2.6-9.5%) and angiotensin II antagonists (6.8%, 95% CI: 5.1-8.6%) during the study period, while the prescribing of digoxin decreased (-4.4%, 95% CI: -8.2 to -0.7). Prescribing of diuretics (difference: -0.7% 95% CI: -2.7-4.2) and ACE inhibitors (difference: 4.0% 95% CI: -0.1-8.2%) remained unchanged.
Prescription of some drug groups for CHF increased. However, given the new scientific evidence that has emerged in past 15 years regarding CHF pharmacotherapy, the changes observed were less than expected.
本研究旨在探讨1996 - 2000年这5年期间慢性心力衰竭（CHF）初级保健处方的趋势。
本研究包括对综合初级保健信息（IPCI）初级保健数据库中的动态队列进行重复横断面调查。该队列包括所有年龄≥55岁、在研究期间被诊断为CHF且开具了心血管药物处方的患者。确定了用于治疗CHF的每种主要药物组的每年点患病率。
研究人群包括3121例CHF患者。在研究期间，开具螺内酯的CHF患者百分比略有增加（4.6%，95%置信区间：2.3 - 6.9%），开具β受体阻滞剂的患者百分比增加（6.1%，95%置信区间：2.6 - 9.5%），开具血管紧张素II拮抗剂的患者百分比增加（6.8%，95%置信区间：5.1 - 8.6%），而地高辛的处方量减少（-4.4%，95%置信区间：-8.2至-0.7）。利尿剂的处方量（差异：-0.7%，95%置信区间：-2.7 - 4.2）和ACE抑制剂的处方量（差异：4.0%，95%置信区间：-0.1 - 8.2%）保持不变。
用于CHF的某些药物组的处方量有所增加。然而，鉴于过去15年中出现的关于CHF药物治疗的新科学证据，观察到的变化小于预期。
