Crisafulli Salvatore, Ientile Valentina, L'Abbate Luca, Fontana Andrea, Linguiti Claudio, Manna Sonia, Mercaldo Mariangela, Pagliaro Claudia, Vezzaro Michele, Santacà Katia, Lora Riccardo, Moretti Ugo, Reno Chiara, Fantini Maria Pia, Corrao Salvatore, Barbato Donato, Tari Michele, Trifirò Gianluca
Department of Medicine, University of Verona, 37134 Verona, Italy.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.
J Clin Med. 2021 Dec 23;11(1):51. doi: 10.3390/jcm11010051.
Evidence on treatments for early-stage COVID-19 in outpatient setting is sparse. We explored the pattern of use of drugs prescribed for COVID-19 outpatients' management in Southern Italy in the period February 2020-January 2021. This population-based cohort study was conducted using COVID-19 surveillance registry from Caserta Local Health Unit, which was linked to claims databases from the same catchment area. The date of SARS-CoV-2 infection diagnosis was the index date (ID). We evaluated demographic and clinical characteristics of the study drug users and the pattern of use of drugs prescribed for outpatient COVID-19 management. Overall, 40,030 patients were included in the analyses, with a median (IQR) age of 44 (27-58) years. More than half of the included patients were asymptomatic at the ID. Overall, during the study period, 720 (1.8%) patients died due to COVID-19. Azithromycin and glucocorticoids were the most frequently prescribed drugs, while oxygen was the less frequently prescribed therapy. The cumulative rate of recovery from COVID-19 was 84.2% at 30 days from ID and it was lower among older patients. In this study we documented that the drug prescribing patterns for COVID-19 treatment in an outpatient setting from Southern Italy was not supported from current evidence on beneficial therapies for early treatment of COVID-19, thus highlighting the need to implement strategies for improving appropriate drug prescribing in general practice.
关于门诊环境中早期新冠肺炎治疗的证据很少。我们探讨了2020年2月至2021年1月期间意大利南部新冠肺炎门诊患者管理所开药物的使用模式。这项基于人群的队列研究使用了卡塞塔地方卫生单位的新冠肺炎监测登记册，该登记册与同一集水区的理赔数据库相关联。严重急性呼吸综合征冠状病毒2感染诊断日期为索引日期（ID）。我们评估了研究药物使用者的人口统计学和临床特征以及为门诊新冠肺炎管理所开药物的使用模式。总体而言，40,030名患者纳入分析，年龄中位数（四分位间距）为44（27 - 58）岁。超过一半的纳入患者在索引日期时无症状。总体而言，在研究期间，720名（1.8%）患者死于新冠肺炎。阿奇霉素和糖皮质激素是最常开具的药物，而氧气是最不常开具的治疗方法。从索引日期起30天时新冠肺炎的累积康复率为84.2%，老年患者的康复率较低。在本研究中，我们记录到意大利南部门诊环境中新冠肺炎治疗的药物处方模式并不受目前关于新冠肺炎早期治疗有益疗法证据的支持，从而突出了在全科医疗中实施改善合理用药策略的必要性。
