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使用分段回归分析英国胃酸抑制剂的处方趋势:评估2019-2024年新冠疫情的影响

Analyzing Prescribing Trends of Gastric Acid Suppressants in the UK Using Segmented Regression: Evaluating the Influence of COVID-19 (2019-2024).

作者信息

Orayj Khalid

机构信息

Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha 61441, Saudi Arabia.

出版信息

Healthcare (Basel). 2025 Feb 20;13(5):442. doi: 10.3390/healthcare13050442.

Abstract

BACKGROUND

This study explored the prescribing patterns of proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) across the UK during the COVID-19 pandemic, highlighting the dynamic relationship between emerging evidence, regulatory actions, and clinical practices.

METHODS

Using a repeated cross-sectional design, prescription data from July 2019 to May 2024 were analyzed across England, Scotland, Wales, and Northern Ireland. Segmented regression analysis was employed to assess trends before and after January 2022, reflecting the impact of emerging evidence on prescribing behaviors.

RESULTS

The results revealed a significant increase in famotidine prescriptions, from 57.56 to 303.31 per 100,000 population in England post-January 2022, reflecting early adoption of preliminary findings despite the lack of randomized controlled trial confirmation. Ranitidine prescriptions fell to near zero due to contamination concerns, while PPIs like omeprazole remained the most prescribed, with Wales reporting the highest post-2022 usage at 7445.71 per 100,000 population.

CONCLUSIONS

Adherence to deprescribing guidelines was inconsistent, with a possibility that many PPI users lacked documented indications. Regional variations in prescribing trends highlighted differences in guideline implementation. These findings underscore the need for improved evidence dissemination and adherence to prescribing guidelines. Future research should include patient-level data and long-term evaluations to optimize healthcare practices.

摘要

背景

本研究探讨了在新冠疫情期间英国各地质子泵抑制剂(PPIs)和组胺H2受体拮抗剂(H2RAs)的处方模式,突出了新出现的证据、监管行动和临床实践之间的动态关系。

方法

采用重复横断面设计,分析了2019年7月至2024年5月英格兰、苏格兰、威尔士和北爱尔兰的处方数据。采用分段回归分析来评估2022年1月前后的趋势,以反映新出现的证据对处方行为的影响。

结果

结果显示,法莫替丁的处方量显著增加,在2022年1月后的英格兰,每10万人中法莫替丁的处方量从57.56增至303.31,这反映出尽管缺乏随机对照试验的证实,但仍提前采用了初步研究结果。由于污染问题,雷尼替丁的处方量降至接近零,而像奥美拉唑这样的质子泵抑制剂仍然是处方量最多的药物,威尔士报告称2022年后的使用量最高,为每10万人7445.71。

结论

对减药指南的遵守情况不一致,许多质子泵抑制剂使用者可能缺乏记录在案的用药指征。处方趋势的地区差异突出了指南实施方面的差异。这些发现强调了改善证据传播和遵守处方指南的必要性。未来的研究应纳入患者层面的数据和长期评估,以优化医疗实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87a5/11898435/d1911d3da237/healthcare-13-00442-g001.jpg

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