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改善非裔美国肾移植受者的用药安全和心血管危险因素控制以减轻差异:设计与方法

Improving Medication Safety and Cardiovascular Risk Factor Control to Mitigate Disparities in African-American Kidney Transplant Recipients: Design and Methods.

作者信息

Cole Andrew J, Johnson Reginald W, Egede Leonard E, Baliga Prabhakar K, Taber David J

机构信息

College of Medicine, Medical University of South Carolina, Charleston, SC.

Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI.

出版信息

Contemp Clin Trials Commun. 2018 Mar;9:1-6. doi: 10.1016/j.conctc.2017.11.008. Epub 2017 Nov 23.

Abstract

There is a lack of data analyzing the influence of cardiovascular disease (CVD) risk factor control on graft survival disparities in African-American kidney transplant recipients. Studies in the general population indicate that CVD risk factor control is poor in African-Americans, leading to higher rates of renal failure and major acute cardiovascular events. However, with the exception of hypertension, there is no data demonstrating similar results within transplant recipients. Recent analyses conducted by our investigator group indicate that CVD risk factors, especially diabetes, are poorly controlled in African-American recipients, which likely impacts graft loss. This study protocol describes a prospective interventional clinical trial with the goal of demonstrating improved medication safety and CVD risk factor control in adult solitary kidney transplant recipients at least one-year post-transplant with a functioning graft. This is a prospective, interventional, 6-month, pharmacist-led and technology enabled study in adult kidney transplant recipients with the goal of improving CVD risk factor outcomes by improving medication safety and patient self-efficacy. This papers describes the issues related to racial disparities in transplant, the details of this intervention and how we expect this intervention to improve CVD risk factor control in kidney transplant recipients, particularly within African-Americans.

摘要

目前缺乏关于心血管疾病(CVD)危险因素控制对非裔美国肾移植受者移植物存活差异影响的数据分析。普通人群研究表明,非裔美国人的CVD危险因素控制不佳,导致肾衰竭和重大急性心血管事件发生率较高。然而,除高血压外,尚无数据表明移植受者中存在类似结果。我们的研究小组最近进行的分析表明,非裔美国受者的CVD危险因素,尤其是糖尿病,控制不佳,这可能会影响移植物丢失。本研究方案描述了一项前瞻性干预临床试验,目标是在移植后至少一年且移植物功能良好的成年单肾移植受者中,证明药物安全性和CVD危险因素控制得到改善。这是一项由药剂师主导、借助技术手段、为期6个月的前瞻性干预研究,对象为成年肾移植受者,目标是通过提高药物安全性和患者自我效能来改善CVD危险因素结局。本文描述了与移植中的种族差异相关的问题、该干预措施的细节以及我们期望该干预措施如何改善肾移植受者,特别是非裔美国人的CVD危险因素控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9cc/5898469/62a5b4c7749a/gr1.jpg

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