临终关怀中治疗心力衰竭药物的可及性。
Availability of Heart Failure Medications in Hospice Care.
作者信息
Lum Hillary D, Horney Carolyn, Koets David, Kutner Jean S, Matlock Daniel D
机构信息
University of Colorado School of Medicine, Department of Medicine, Aurora, CO, USA
Veterans Affairs Eastern Colorado Health Care System, Denver, CO, USA.
出版信息
Am J Hosp Palliat Care. 2016 Dec;33(10):924-928. doi: 10.1177/1049909115603689. Epub 2015 Aug 31.
BACKGROUND
Availability of cardiac medications in hospice for acute symptom management of heart failure is unknown. This study explored hospice approaches to cardiac medications for patients with heart failure.
METHODS
Descriptive study using a quantitative survey of 46 US hospice agencies and clinician interviews.
RESULTS
Of 31 hospices that provided standard home medication kits for acute symptom management, only 1 provided medication with cardiac indications (oral furosemide). Only 22% of the hospice agencies had a specific cardiac medication kit. Just over half (57%) of the agencies could provide intravenous inotropic therapy, often in multiple hospice settings. Clinicians described an individualized approach to cardiac medications for patients with heart failure.
CONCLUSION
This study highlights opportunities for practice guidelines that inform medical therapy for hospice patients with heart failure.
背景
临终关怀机构中用于心力衰竭急性症状管理的心脏药物供应情况尚不清楚。本研究探讨了临终关怀机构针对心力衰竭患者使用心脏药物的方法。
方法
采用描述性研究，对46家美国临终关怀机构进行定量调查并对临床医生进行访谈。
结果
在31家提供用于急性症状管理的标准家庭药盒的临终关怀机构中，只有1家提供有心脏适应症的药物（口服呋塞米）。只有22%的临终关怀机构有特定的心脏药盒。略超过一半（57%）的机构能够提供静脉注射正性肌力治疗，且通常是在多个临终关怀机构环境中。临床医生描述了针对心力衰竭患者使用心脏药物的个体化方法。
结论
本研究突出了制定实践指南的机会，这些指南可为临终关怀的心力衰竭患者的药物治疗提供指导。
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