Ho Chen-Pei, Yeh Jih-I, Wen Shu-Hui, Lee Tony Jer-Fu
Department of Pharmacy, Buddhist Tzu Chi General Hospital Institute of Medical Sciences, College of Medicine Department of Molecular Biology and Human Genetics, Tzu Chi University Department of Family Medicine, Buddhist Tzu Chi General Hospital Department of Public Health, College of Medicine, Tzu Chi University Department of Medical Research, Buddhist Tzu Chi General Hospital Department of Life Sciences, College of Life Sciences, Tzu Chi University, Hualien, Taiwan Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL.
Medicine (Baltimore). 2017 Nov;96(45):e8497. doi: 10.1097/MD.0000000000008497.
The aim of this study was to explore the associations among the medication regimen complexity index (MRCI), medical specialty, and medication possession ratio (MPR) in newly diagnosed hypertensive patients.Data from 19,859 newly diagnosed hypertensive patients were collected from 2,000,000 random samples of the National Health Insurance Research Database in Taiwan. All study participants were followed for 1 year after the first diagnosis of hypertension. MPR was defined as total days of antihypertensive drugs supplied/365 days. MRCI was calculated on the basis of the type of dosage forms, dosing frequency, and additional directions for use of antihypertensive drugs. Patients were further restricted to those who visited the same medical specialty to examine specialty-specific variations in the MRCI and MPR.The mean MPR was 54.83%, and the sample sizes for the low-, medium-, and high-MPR groups were 9806 (49.38%), 4619 (23.26%), and 5434 (27.36%), respectively. More than 50% of the patients visited the same medical specialty during the 1-year follow-up. The mean MRCI was 3.64; the cardiology specialty had the highest MRCI, and the family medicine specialty had the lowest. Multiple linear regression analyses showed that MRCI was negatively associated with MPR (β = -7.75, P ≤ .01) whether or not the patients visited the same medical specialty. For the patients who visited the same medical specialty, those treated by endocrinology and metabolism specialists had a significantly higher MPR (β = 9.87, P ≤ .01) than that of those treated by family medicine specialists.MRCI and medical specialty were both significantly associated with the MPR of newly diagnosed hypertensive patients.
本研究旨在探讨新诊断高血压患者的药物治疗方案复杂性指数（MRCI）、医学专科与药物持有率（MPR）之间的关联。从台湾国民健康保险研究数据库的200万个随机样本中收集了19859例新诊断高血压患者的数据。所有研究参与者在首次诊断高血压后随访1年。MPR定义为供应的抗高血压药物总天数/365天。MRCI根据抗高血压药物的剂型、给药频率和附加使用说明进行计算。患者进一步限制为就诊于同一医学专科的患者，以检查MRCI和MPR在专科方面的差异。平均MPR为54.83%，低、中、高MPR组的样本量分别为9806例（49.38%）、4619例（23.26%）和5434例（27.36%）。超过50%的患者在1年随访期间就诊于同一医学专科。平均MRCI为3.64；心脏病专科的MRCI最高，家庭医学专科的MRCI最低。多元线性回归分析表明，无论患者是否就诊于同一医学专科，MRCI与MPR均呈负相关（β=-7.75，P≤0.01）。对于就诊于同一医学专科的患者，内分泌和代谢专科医生治疗的患者的MPR显著高于家庭医学专科医生治疗的患者（β=9.87，P≤0.01）。MRCI和医学专科均与新诊断高血压患者的MPR显著相关。
