■在越南,没有对口服抗凝药的处方和监测实践进行调查,以确保房颤患者接受适当的治疗.目标:因此,我们进行这项研究是为了澄清我们医院的上述问题.
■我们在胡志明市的大学医学中心通过审查门诊电子病历进行了横断面研究。我们的研究包括1087名年龄在18岁或以上的诊断为非瓣膜性心房颤动(NVAF)的患者,他在1月1日期间参观了心脏病诊所,2021年6月30日,2021年。
■在1087例非瓣膜性心房颤动(NVAF)患者中,1036例符合抗凝治疗的条件。然而,只有847例(81.8%)接受了维生素K拮抗剂(VKAs)(n=129,15.2%)或非维生素K拮抗剂口服抗凝药(NOACs)(n=718,84.8%)的处方.NOAC处方更常见于75岁或以上的患者(调整后比值比[OR]=2),那些有健康保险的人(调整后的OR=2.9),以及有高血压病史的个体(调整后的OR=2)。相反,从事农业职业的患者服用NOAC的可能性较小(校正后的OR=0.4).大约75%的患者遵守指南,建议在抗凝治疗期间进行密切监测。值得注意的是,在27.7%的病例中发现了不适当的处方,尤其是那些没有记录体重的人(这是基于肌酐清除率的精确给药所必需的),那些没有医疗保险的人,那些没有记录的CHA2DS2-VASc分数的人,或同时使用抗血小板药物的患者。
在诊断和管理非瓣膜性心房颤动(NVAF)患者方面,临床指南与实际实践之间存在差异。至关重要的是,在随访预约时定期重新评估血栓栓塞风险评分。确保严格遵守临床监测标准,并使抗凝药物处方与既定指南保持一致。
UNASSIGNED: In Vietnam, there has been no survey conducted on the prescribing and monitoring practices of oral anticoagulants to ensure that patients with atrial fibrillation receive appropriate. Objective: Therefore, we conducted this research to clarify the aforementioned issue in our hospital.
UNASSIGNED: We carried out a cross-sectional study by reviewing outpatient electronic medical records at the University Medical Center in Ho Chi Minh City. Our study included 1087 patients aged 18 years or older diagnosed with non-valvular atrial fibrillation (NVAF), who visited the Cardiology clinic between January 1st, 2021, and June 30th, 2021.
UNASSIGNED: Among the 1087 patients with non-valvular atrial fibrillation (NVAF), 1036 were eligible for anticoagulant therapy. However, only 847 (81.8%) received prescriptions for either Vitamin K antagonists (VKAs) (n=129, 15.2%) or Non-Vitamin K antagonist oral anticoagulants (NOACs) (n=718, 84.8%). NOAC prescriptions were more commonly found in patients aged 75 or older (adjusted odds ratio [OR]=2), those with health insurance coverage (adjusted OR=2.9), and in individuals with a history of hypertension (adjusted OR=2). On the contrary, patients with a farming occupation were less likely to be prescribed NOACs (adjusted OR=0.4). About 75% of patients adhered to the guidelines recommending close monitoring during anticoagulant treatment. Notably, inappropriate prescriptions were identified in 27.7% of cases, especially among those with no recorded body weight (which is necessary for precise dosing based on creatinine clearance), those without health insurance, those with undocumented CHA2DS2-VASc scores, or those who were concurrently using antiplatelet agents.
UNASSIGNED: A discrepancy persists between clinical guidelines and the actual practice in diagnosing and managing patients with non-valvular atrial fibrillation (NVAF). It is crucial to prioritize the regular reevaluation of thromboembolic risk scores at follow-up appointments, ensure strict adherence to clinical monitoring standards, and align anticoagulant medication prescriptions with established guidelines.