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心血管预防治疗的联合处方模式:西班牙阿拉贡工人健康研究中的一项横断面研究。

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

机构信息

Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.

Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.

出版信息

BMJ Open. 2019 Apr 14;9(4):e023571. doi: 10.1136/bmjopen-2018-023571.

Abstract

OBJECTIVES

To identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.

DESIGN

Cross-sectional study.

SETTING

Aragon Workers' Health Study (AWHS) cohort in Spain.

PARTICIPANTS

5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).

PRIMARY AND SECONDARY OUTCOME MEASURES

Drug consumption was obtained from the Aragon Pharmaceutical Consumption Registry (Farmasalud). In order to know treatment utilisation, prevalence analyses were conducted. Frequent item set mining techniques were applied to identify drugs co-prescription patterns. All the results were stratified by sex and age.

RESULTS

42.3% of men and 18.8% of women in the cohort received, at least, three prescriptions of a CVD preventive treatment in 2014. The most prescribed CVD treatment were antihypertensives (men: 28.2%, women 9.2%). The most frequent association observed among CVD preventive treatment was agents acting on the renin-angiotensin system and lipid-lowering drugs (5.1% of treated subjects). Co-prescription increased with age, especially after 50 years old, both in frequency and number of associations, and was higher in men. Regarding the association between CVD preventive treatments and other drugs, the most frequent pattern observed was lipid-lowering drugs and drugs used for acid related disorders (4.2% of treated subjects).

CONCLUSIONS

There is an important number of co-prescription patterns that involve CVD preventive treatments. These patterns increase with age and are more frequent in men. Mining techniques are a useful tool to identify pharmacological patterns that are not evident in the individual clinical practice, in order to improve drug prescription appropriateness.

摘要

目的

确定心血管疾病(CVD)预防治疗的联合用药方案,包括这些方案以及与其他药物的联合用药方案,并确定它们在西班牙工人队列中的流行程度。

设计

横断面研究。

设置

西班牙阿龙工人健康研究(AWHS)队列。

参与者

属于 AWHS 队列的 5577 名工人。从这些受试者中,我们选择了那些在 2014 年至少有三种相同治疗亚组的处方的受试者(n=4605)。

主要和次要观察指标

药物消耗是从阿龙制药消费登记处(Farmasalud)获得的。为了了解治疗的使用情况,我们进行了患病率分析。应用频繁项集挖掘技术来识别药物共同处方模式。所有结果都按性别和年龄进行分层。

结果

2014 年,队列中 42.3%的男性和 18.8%的女性至少接受了三种 CVD 预防治疗的处方。最常开的 CVD 治疗药物是降压药(男性:28.2%,女性:9.2%)。观察到 CVD 预防治疗中最常见的联合用药是肾素-血管紧张素系统制剂和降脂药物(5.1%的治疗对象)。联合用药随着年龄的增长而增加,尤其是在 50 岁以后,无论是在频率还是在联合用药的数量上,而且在男性中更为常见。关于 CVD 预防治疗与其他药物的联合使用,观察到的最常见模式是降脂药物和用于酸相关疾病的药物(4.2%的治疗对象)。

结论

存在大量涉及 CVD 预防治疗的联合用药模式。这些模式随着年龄的增长而增加,在男性中更为常见。挖掘技术是一种有用的工具,可以识别在个体临床实践中不明显的药物模式,以提高药物处方的适当性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/890e/6500350/63249d5db6d8/bmjopen-2018-023571f01.jpg

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