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慢性阻塞性肺疾病的处方实践:1999 - 2010年国家门诊医疗调查结果

Prescription practices for chronic obstructive pulmonary disease: findings from the national ambulatory medical care survey 1999-2010.

作者信息

Ford Earl S, Mannino David M, Giles Wayne H, Wheaton Anne G, Liu Yong, Croft Janet B

机构信息

1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

出版信息

COPD. 2014 Jun;11(3):247-55. doi: 10.3109/15412555.2013.840570. Epub 2014 Feb 25.

Abstract

Recent trends in prescriptions for medicines used to treat chronic obstructive pulmonary disease (COPD) in the United States have received little attention. Our objective was to examine trends in prescribing practices for medications used to treat COPD. We examined data from surveys of national samples of office visits to non-federal employed office-based physicians in the United States by patients aged ≥40 years with COPD recorded by the National Ambulatory Medical Care Survey from 1999 to 2010. From three diagnostic codes, office visits by patients with COPD were identified. Prescribed medications were identified from up to 8 recorded medications. The percentage of these visits during which a prescription for any medication used to treat COPD was issued increased from 27.0% in 1999 to 49.1% in 2010 (p trend < 0.001). Strong increases were noted for short-acting beta-2 agonists (17.6% in 1999 to 24.7% in 2010; p trend < 0.001), long-acting beta-2 agonists as single agents or combination products (6.2% in 1999 to 28.3% in 2010; p trend < 0.001), inhaled corticosteroids as single agents or combination products (10.9% in 1999 to 30.9% in 2010; p trend < 0.001), and tiotropium (3.8% in 2004 to 17.2% in 2010; p trend < 0.001). Since 1999, prescription patterns for medicines used to treat COPD have changed profoundly in the United States.

摘要

美国用于治疗慢性阻塞性肺疾病(COPD)药物的处方近期趋势很少受到关注。我们的目标是研究用于治疗COPD药物的处方实践趋势。我们研究了1999年至2010年美国国家门诊医疗调查记录的≥40岁COPD患者就诊于非联邦受雇的门诊医生的全国样本调查数据。通过三个诊断代码识别出COPD患者的就诊情况。从最多8种记录的药物中识别出所开的药物。开具任何用于治疗COPD药物处方的就诊比例从1999年的27.0%增加到2010年的49.1%(p趋势<0.001)。短效β2激动剂(从1999年的17.6%增至2010年的24.7%;p趋势<0.001)、长效β2激动剂单药或复方制剂(从1999年的6.2%增至2010年的28.3%;p趋势<0.001)、吸入性糖皮质激素单药或复方制剂(从1999年的10.9%增至2010年的30.9%;p趋势<0.001)以及噻托溴铵(从2004年的3.8%增至2010年的17.2%;p趋势<0.001)均有显著增加。自1999年以来,美国用于治疗COPD药物的处方模式发生了深刻变化。

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