treatment adherence

治疗依从性
  • 文章类型: Journal Article
    目的:偏头痛是世界范围内最常见的慢性神经系统疾病之一。尽管已经推荐了多种治疗方案,没有足够的证据证明哪种治疗模式适用于常规临床.
    方法:我们使用了韩国2015-2021年的全国索赔数据,以确定至少有一种偏头痛处方的偏头痛患者。根据患者的初始治疗类别对患者进行分类,并从治疗开始之日起进行随访。治疗方案包括预防性治疗(抗抑郁药,抗惊厥药,β受体阻滞剂,钙通道阻滞剂,和肾素-血管紧张素-醛固酮系统[RAAS]抑制剂)和急性治疗(对乙酰氨基酚,止吐药,阿司匹林,麦角胺,非甾体抗炎药[NSAIDs],阿片类药物,和曲坦)。对偏头痛的治疗模式进行评估,直至研究期结束。包括长期趋势,患病率,持久性,和偏头痛治疗的变化。
    结果:在761,350名接受偏头痛治疗的患者中,最常见的急性治疗是NSAID(69.9%),其次是对乙酰氨基酚(50.0%)。处方最多的预防性治疗是氟桂利嗪(36.9%),其次是普萘洛尔(24.4%)。在患者中,54.8%接受急性治疗,13.5%接受预防性治疗,31.6%接受两种治疗。然而,65.7%的患者在3个月内停止治疗。在急性治疗中,曲坦类药物的3个月存留率最高(25.2%),在预防性治疗中,RAAS抑制剂的3个月存留率最高(62.0%)。
    结论:虽然发现药物使用的患病率与当前的偏头痛指南一致,在常规临床环境中观察到药物的频繁转换和快速停药.
    OBJECTIVE: Migraine is one of the most common chronic neurological diseases worldwide. Although diverse treatment regimens have been recommended, there is insufficient evidence for which treatment patterns to apply in routine clinical settings.
    METHODS: We used nationwide claims data from South Korea for 2015-2021 to identify incident migraine patients with at least one prescription for migraine. Patients were categorized according to their initial treatment classes and followed up from the date of treatment initiation. Treatment regimens included prophylactic treatments (antidepressants, anticonvulsants, beta blockers, calcium-channel blockers, and renin-angiotensin-aldosterone system [RAAS] inhibitors) and acute treatments (acetaminophen, antiemetics, aspirin, ergotamine, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, and triptans). The treatment patterns of migraine were evaluated until the end of the study period, including the secular trends, prevalence, persistence, and changes in migraine treatment.
    RESULTS: Among the 761,350 included patients who received migraine treatment, the most frequently prescribed acute treatment was an NSAID (69.9%), followed by acetaminophen (50.0%). The most-prescribed prophylactic treatment was flunarizine (36.9%), followed by propranolol (24.4%). Among the patients, 54.8% received acute treatment, 13.5% received prophylactic treatment, and 31.6% received both treatment types. However, 65.7% of the patients discontinued their treatment within 3 months. The 3-month persistence rate was highest for triptans (25.2%) among the acute treatments and for RAAS inhibitors (62.0%) among the prophylactic treatments.
    CONCLUSIONS: While the prevalence rates of medication use were found to align with current migraine guidelines, frequent switching and rapid discontinuation of drugs were observed in routine clinical settings.
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  • 文章类型: Journal Article
    坚持治疗对于肺结核的管理至关重要。护士和医疗保健专业人员在促进该人群的依从性行为方面发挥着重要作用。然而,在这一特定人群中定义对治疗的依从性仍然很复杂.
    本研究旨在探索和阐明肺结核患者坚持治疗的概念。
    罗杰斯的进化概念分析被用于本研究。在PubMed和Scopus数据库中进行了文献检索,以确定2013年7月至2023年7月发表的相关研究。
    肺结核坚持治疗的属性包括多个组成部分:生物学,个人,社会,卫生服务,和决策过程。因素包括各种患者相关因素以及与临床状况和患者健康专业参与相关的因素。该概念出现了三个后果:增强治疗功效,增加对结核病治疗依从性的承诺,提高卫生服务质量。
    这项研究提供了对结核病治疗依从性的全面操作定义,包括它的属性,前身,和后果。该框架将帮助护士更有效地评估依从性。然而,需要进一步研究坚持结核病治疗的个人的经验,以确认和加强这些策略。
    UNASSIGNED: Adherence to treatment is essential for the management of pulmonary tuberculosis. Nurses and healthcare professionals play a significant role in promoting adherence behavior among this population. Nevertheless, defining adherence to treatment within this particular population remains complex.
    UNASSIGNED: This study aimed to explore and clarify the concept of adherence to treatment among individuals with pulmonary tuberculosis.
    UNASSIGNED: Rodgers\' evolutionary concept analysis was employed in this study. A literature search was conducted in the PubMed and Scopus databases to identify relevant studies published between July 2013 and July 2023.
    UNASSIGNED: The attributes of adherence to treatment in pulmonary tuberculosis consist of multiple components: biological, individual, social, health service, and policy-making processes. Antecedents include various patient-related factors as well as factors associated with clinical conditions and patient-health professional engagement. Three consequences of the concept have emerged: enhanced treatment efficacy, increased commitment to tuberculosis treatment adherence, and improved health service quality.
    UNASSIGNED: This study provides a comprehensive operational definition of adherence to tuberculosis treatment, including its attributes, antecedents, and consequences. This framework will assist nurses in evaluating adherence more effectively. However, further research into the experiences of individuals adhering to tuberculosis treatment is needed to confirm and enhance these strategies.
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  • 文章类型: Journal Article
    心力衰竭(HF)仍然是全球医疗保健系统的重大负担。需要创新的管理方法。该手稿严格评估了远程监控和远程医疗在彻底改变HF护理交付中的作用。根据当前文献和临床实践的综合,它描绘了关键的好处,挑战,以及与这些技术相关的个性化策略。分析强调了远程监测和远程医疗在促进及时干预方面的潜力,增强患者参与度,优化治疗依从性,从而改善临床结果。然而,复杂的技术,监管框架,和社会经济因素构成了广泛采用的巨大障碍。手稿强调了量身定制的干预措施的必要性,利用人工智能和机器学习的进步,有效地满足患者的个人需求。展望未来,持续创新,跨学科合作,并提倡战略投资,以实现HF管理中远程监控和远程医疗的变革潜力,从而推进以患者为中心的护理模式,优化医疗资源配置。
    Heart failure (HF) remains a significant burden on global healthcare systems, necessitating innovative approaches for its management. This manuscript critically evaluates the role of remote monitoring and telemedicine in revolutionizing HF care delivery. Drawing upon a synthesis of current literature and clinical practices, it delineates the pivotal benefits, challenges, and personalized strategies associated with these technologies in HF management. The analysis highlights the potential of remote monitoring and telemedicine in facilitating timely interventions, enhancing patient engagement, and optimizing treatment adherence, thereby ameliorating clinical outcomes. However, technical intricacies, regulatory frameworks, and socioeconomic factors pose formidable hurdles to widespread adoption. The manuscript emphasizes the imperative of tailored interventions, leveraging advancements in artificial intelligence and machine learning, to address individual patient needs effectively. Looking forward, sustained innovation, interdisciplinary collaboration, and strategic investment are advocated to realize the transformative potential of remote monitoring and telemedicine in HF management, thereby advancing patient-centric care paradigms and optimizing healthcare resource allocation.
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  • 文章类型: Journal Article
    胱抑素病是一种罕见的常染色体隐性遗传疾病,其中胱氨酸晶体在细胞溶酶体内积聚,对多个器官造成损害.由于严格的半胱胺治疗方案和副作用的挑战,坚持往往是次优的。这项研究旨在评估沙特阿拉伯的膀胱炎患者对半胱胺治疗的依从性水平及其对生活质量的影响。对沙特阿拉伯费萨尔国王专科医院和研究中心肾内科的39名膀胱病患者的电子病历数据进行了审查,25例患者纳入本研究。在最终分析的25名患者中,64%(n=16)为女性。平均年龄为19.04岁。几乎所有患者(23/25,92%)都在口服IR半胱胺治疗,和52%(13/25)的局部半胱胺滴眼液治疗。在对Morisky药物依从性量表-8(MMAS-8)问卷做出回应的15名患者中,只有4例(26.7%)高度粘附于半胱胺治疗.大多数受访者(7/15,46.7%)表现出中等水平的治疗依从性。根据口服半胱胺的药物持有率,23例患者中只有6例(26.1%)的粘附率为96-100%。半胱胺滴眼液,只有5/13的患者(38.4%)有76-95%的粘附。用于评估患者健康相关结果的36项简表健康调查(SF-36)表明,他们的生活质量在“社会功能”和“能量/疲劳”领域受到影响。\'尽管样本量很小,本研究显示沙特阿拉伯患者对半胱胺治疗的依从性次优.低治疗依从性的可能原因可能是高频率的给药和治疗相关的副作用。
    Cystinosis is a rare autosomal recessive disorder in which cystine crystals accumulate within the cellular lysosomes, causing damage to multiple organs. Due to challenges with the stringent cysteamine treatment regimen and side effects, adherence is often sub-optimal. This study aimed to assess the level of adherence to cysteamine therapy among cystinosis patients in Saudi Arabia and its impact on their quality of life. Electronic medical record data of 39 cystinosis patients from the Department of Nephrology at King Faisal Specialist Hospital and Research Center in Saudi Arabia were reviewed, and 25 patients were included in this study. Out of the 25 patients included in the final analysis, 64% (n = 16) were female. The mean age was 19.04 years. Almost all patients (23/25, 92%) were on oral IR cysteamine therapy, and 52% (13/25) were on topical cysteamine eye drop treatment. Of the 15 patients who responded to the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire, only 4 (26.7%) were highly adherent to cysteamine therapy. Most of the respondents (7/15, 46.7%) showed a medium level of treatment adherence. Based on the medication possession ratio for oral cysteamine, only 6 out of 23 patients (26.1%) were found to be 96-100% adherent. For the cysteamine eye drops, only 5/13 patients (38.4%) were 76-95% adherent. The 36-Item Short Form Health Survey (SF-36) used to assess patients\' health-related outcomes showed that their quality of life was affected in the domains of \'social functioning\' and \'energy/fatigue.\' Despite a small sample size, this study shows sub-optimal adherence to cysteamine treatment in patients from Saudi Arabia. The possible reasons for low treatment adherence could be a high frequency of administration and treatment-related side effects.
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  • 文章类型: Journal Article
    背景:将2型糖尿病(T2D)作为慢性疾病的管理需要坚持治疗,例如控制血糖水平和采取健康的生活方式。本研究旨在基于Pender的健康促进模型(HPM)开发和心理评估问卷,以测量T2D患者的治疗依从性和相关因素。
    方法:本研究在2022年3月至2023年3月之间进行了定性和定量阶段。参与者是在伊朗南部阿巴斯港的ShahidMohammadi医院糖尿病诊所就诊的T2D患者。项目初稿是从定性阶段提取的。本研究使用了对T2D患者的访谈,项目施工,仪器的有效性和可靠性评估,以及相关的统计分析。它强调了内容的重要性,脸,并构建效度,以及使用Cronbachα和测试重测方法的可靠性测试。数据采用SPSS软件进行分析,V16和AMOS,V23.
    结果:通过定性阶段开发了97项问卷,在内容有效性之后,减少到86个项目。面部验证中删除了五个项目,在测试-重测方法之后,保留了79个项目。验证性因素分析证实了具有适当数据适合性的65项模型。Cronbach的α系数显示糖尿病治疗依从性问卷的可靠性可接受(α=0.92)。
    结论:基于HPM模型开发的问卷提供了对伊朗T2D患者坚持治疗程度和相关因素的标准和全面测量。这在伊朗的医疗保健环境中尤其有价值,在那里,有效管理糖尿病等慢性疾病是重中之重。问卷调查可以帮助确定治疗依从性的障碍和促进者,以告知系统和面向目标的干预措施。提出的问卷具有良好的心理测量学特性,并且可以用作有效和实用的工具来测量与治疗依从性行为相关的因素。
    BACKGROUND: Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender\'s Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients.
    METHODS: The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach\'s alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23.
    RESULTS: A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach\'s alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92).
    CONCLUSIONS: The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors.
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  • 文章类型: Journal Article
    确定阻塞性睡眠呼吸暂停(OSA)患者的自我效能感在医疗保健实践中具有关键作用。进一步评估,睡眠呼吸暂停自我效能量表(SEMSA)可作为一个有用的量表,用于制定特定干预措施,以提高OSA患者接受和维持持续气道正压(CPAP)治疗期间的自我效能.
    本研究的目的是将SEMSA翻译成土耳其语,并评估翻译的心理测量特性。
    这项横断面研究是对最近诊断为CPAP初治OSA的患者样本进行的。对量表的语言效度和内容效度进行了评价,而探索性因素分析和2水平验证性因素分析用于有效性。在可靠性分析中使用内部一致性和重测方法。
    OSA患者的平均(SD)年龄为51.36(11.29),68%是男性。作为验证性因子分析的结果获得的项目因子载荷范围为0.44至0.94,证实了仪器的三因子结构。该量表的Cronbach'sα系数为0.90。在测试-重测分析范围内进行的测量被发现是相关的,并且在干预时间内获得了一致的结果(P<.01)。
    在这项研究中,土耳其版SEMSA被认为是一种有效且可靠的工具,可用于评估土耳其OSA患者CPAP治疗后的依从性相关认知.
    UNASSIGNED: Determining the self-efficacy perceptions of obstructive sleep apnea (OSA) patients has a key role in health care practices. With further evaluation, the Self-Efficacy Measure for Sleep Apnea (SEMSA) could serve as a useful scale to develop specific interventions to increase self-efficacy in patients with OSA during the acceptance and maintenance of continuous positive airway pressure (CPAP) therapy.
    UNASSIGNED: The aim of this study is to translate the SEMSA into Turkish and to evaluate the psychometric properties of the translation.
    UNASSIGNED: This cross-sectional study was carried out with a sample of patients recently diagnosed with CPAP-naïve OSA. Linguistic and content validity of the scale were evaluated, while exploratory factor analysis and 2-level confirmatory factor analysis were used for validity. Internal consistency and test-retest methods were used in reliability analyses.
    UNASSIGNED: The mean (SD) age of the patients with OSA was 51.36 (11.29), and 68% were male. The item factor loads obtained as a result of the confirmatory factor analysis ranged from 0.44 to 0.94, confirming the three-factor structure of the instrument. The Cronbach\'s α coefficient of the scale was found to be 0.90. Measurements made within the scope of test-retest analysis were found to be related and consistent results were obtained in the intervening time (P < .01).
    UNASSIGNED: In this study, the Turkish version of SEMSA was found to be a valid and reliable tool and it could be used to evaluate the adherence-related cognition in Turkish patients with OSA on CPAP therapy.
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  • 文章类型: Journal Article
    关于在特发性身材矮小(ISS)儿童中使用长效聚乙二醇重组人生长激素(PEG-rhGH)存在一些证据空白,特别是在现实世界中进行的研究,通过长期随访,涉及不同的给药方案,与每日rhGH相比。该研究旨在评估有效性,安全,与每日rhGH相比,每周一次PEG-rhGH对青春期前ISS儿童的追赶生长的依从性。在中国的ISS青春期前儿童中进行了一项真实世界的回顾性队列研究。纳入自愿接受每周一次PEG-rhGH或每日一次rhGH的儿童,并随访2年。其中包括95名儿童,47例每周接受PEG-rhGH0.2-0.3mg/kg,48例每天接受rhGH。成果衡量指标包括追赶增长的有效性,不良事件,和治疗依从性。在rhGH治疗期间,两组的身高速度均显着增加。在接受PEG-rhGH治疗的儿童中,第一年和第二年的身高速度分别为10.59±1.37厘米/年和8.75±0.86厘米/年,分别,显着高于每天接受rhGH的人(9.80±1.05厘米/年,P=0.002,8.03±0.89厘米/年,P<0.001)。所有患儿的身高标准差评分在第二年末均有改善(P<0.001)。然而,接受PEG-rhGH的儿童比每天接受rhGH的儿童表现出更好的改善(1.65±0.38vs.1.50±0.36,P=0.001)。在接受PEG-rhGH的儿童中,与每日rhGH相比,观察到的错过剂量较低(0.75±1.06vs.4.4±2.0,P<0.001)。未观察到严重不良事件。
    结论:PEG-rhGH与每日rhGH相比,在治疗ISS患儿方面表现出更好的有效性和依从性。两种治疗之间的安全性特征相似。
    背景:•重组人生长激素(rhGH)已用于增加特发性身材矮小(ISS)儿童的成人身高,其安全性与生长激素治疗的其他适应症相当。•在ISS儿童中使用长效rhGH仍然是一个不确定的领域。
    背景:•这项为期2年的现实世界研究提供了新的证据,表明PEG化rhGH(PEG-rhGH)在促进ISS儿童的追赶生长方面比日常rhGH更有效。•PEG-rhGH在ISS儿童中也表现出优于每日rhGH的治疗依从性。•发现PEG-rhGH和每日rhGH的安全性特征相似。
    Several evidence gaps exist regarding the use of long-acting polyethylene glycol recombinant human growth hormone (PEG-rhGH) in children with idiopathic short stature (ISS), particularly studies conducted in real-world settings, with long-term follow-up, involving varied dosing regimens, and in comparison with daily rhGH. The study aimed to evaluate the effectiveness, safety, and adherence of once-weekly PEG-rhGH for catch-up growth in children with prepubertal ISS compared to daily rhGH. A real-world retrospective cohort study was conducted in prepubertal children with ISS in China. Children who voluntarily received once-weekly PEG-rhGH or daily rhGH were included and were followed up for 2 years. Ninety-five children were included, 47 received PEG-rhGH 0.2-0.3 mg/kg weekly and 48 received daily rhGH. Outcome measures included effectiveness in catch-up growth, adverse events, and treatment adherence. Height velocity increased significantly in both groups during rhGH therapy. In children who received PEG-rhGH treatment, height velocity was 10.59 ± 1.37 cm/year and 8.75 ± 0.86 cm/year in the first and second year, respectively, which were significantly more than those who received daily rhGH (9.80 ± 1.05 cm/year, P = 0.002, and 8.03 ± 0.89 cm/year, P < 0.001). The height standard deviation score improved at the end of the second year for all children (P < 0.001). However, children who received PEG-rhGH showed more excellent improvement than those with daily rhGH (1.65 ± 0.38 vs. 1.50 ± 0.36, P = 0.001). In children who received PEG-rhGH, lower missed doses were observed than those with daily rhGH (0.75 ± 1.06 vs. 4.4 ± 2.0, P < 0.001). No serious adverse events were observed.
    CONCLUSIONS: PEG-rhGH demonstrated superior effectiveness and adherence compared to daily rhGH in the treatment of children with ISS. The safety profiles were similar between the two treatments.
    BACKGROUND: • Recombinant human growth hormone (rhGH) has been used to increase adult height in children with idiopathic short stature (ISS), and its safety profile is comparable to other indications for growth hormone treatment. • The use of long-acting rhGH in children with ISS is still an area of uncertainty.
    BACKGROUND: • This 2-year real-world study provides new evidence that PEGylated rhGH (PEG-rhGH) is more effective than daily rhGH in promoting catch-up growth in children with ISS. • PEG-rhGH also demonstrated superior treatment adherence compared to daily rhGH in children with ISS. • The safety profiles of PEG-rhGH and daily rhGH were found to be similar.
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  • 文章类型: Case Reports
    监测剂量系统(MDS)是一种有效的、可靠的和批准的设备在药房的药物再处理。这些系统意味着对适当的药物使用以及初级卫生保健与药剂师之间的合作进行审查。该案例研究描述了2021年和2022年因腰痛而进行手术干预的女性患者。患者描述了与不当药物使用相关的不受控制的慢性疼痛和混乱。在定期配药期间,检测到这些药物相关问题(MRP),并将患者转诊至MDS服务.实施后,消除了患者的困惑,实现了疼痛管理,提高她的生活质量。作为结论,药房提供的不同健康服务可以提高患者的生活质量,治疗依从性和MRP检测。
    Monitored Dosage Systems (MDS) are an efficient, reliable and approved device for drug reconditioning in pharmacy. These systems imply a review on proper drug use and the collaboration between primary health care and pharmacists. The case study describes a female patient with a surgical intervention due to lumbosciatica in 2021 and 2022. Patient describes uncontrolled chronic pain and confusion related to improper drug use. During regular dispensing of her medication, these medicine-related problems (MRP) were detected and the patient was referred to the MDS service. After its implementation, the patient\'s confusion was eliminated and pain management was achieved, increasing her quality of life. As a conclusion, the different health services provided by the pharmacy can improve a patient\'s quality of life, treatment adherence and MRP detection.
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  • 文章类型: Journal Article
    长效注射(LAI)抗精神病药物可改善患者的治疗效果,并被治疗指南推荐用于精神分裂症患者服药依从性有限的患者,双极,和其他精神病。缺乏在这些疾病中使用LAI抗精神病药以及是否与治疗指南一致的报告。这项研究旨在报告与这些疾病中使用LAI抗精神病药相关的患者特征。
    对≥18岁的双相或精神病患者进行回顾性观察研究,集成,以社区为基础的卫生系统。从2017年1月1日至2023年12月31日,患者人口统计学和临床特征作为LAI与口服抗精神病药物使用的调整比值比(aOR)的主要结果的暴露。
    有N=2685LAI和N=31531口服抗精神病药使用者。非白人(aOR=1.3-2.0;P<0.0001),非女性(aOR=1.5;P<0.0001),来自一个高度剥夺的社区(NDI,aOR=1.3;P<.0007),具有较高的体重指数(BMI,OR=1.3-1.7;P<.0009),患有精神分裂症/分裂情感性(aOR=5.8-6.8;P<0.0001),精神病患者(aOR=1.6,P<0.0001),或物质使用障碍(aOR=1.4;P<0.0001),和门诊精神病学(aOR=2.3-7.5;P<.0001)或住院(aOR=2.4;P<.0001)在前一年中的使用率较高,年龄≥40岁(aOR=0.4-0.7;P<.0001)或双相情感障碍(aOR=0.9;P<.05)与使用LAI的几率较低相关。非白色,非女性,年龄18~39岁,无论治疗依从性指标如何,高NDI患者的LAI使用率均较高.吸烟和心脏代谢标志物也与LAI使用相关。
    人口统计学和临床因素与LAI使用增加相关,而与治疗依从性无关。有必要研究利用差异,以告知与治疗指南建议一致的公平配方使用。
    UNASSIGNED: Long-acting injectable (LAI) antipsychotics improve patient outcomes and are recommended by treatment guidelines for patients with limited medication adherence in schizophrenia spectrum, bipolar, and other psychotic disorders. Reports of LAI antipsychotic use in these disorders and if use aligns with treatment guidelines are lacking. This study aimed to report patient characteristics associated with LAI antipsychotic use in these disorders.
    UNASSIGNED: Retrospective observational study of patients ≥18-years-old with bipolar or psychotic disorders at a large, integrated, community-based health system. Patient demographic and clinical characteristics served as exposures for the main outcome of adjusted odds ratio (aOR) for LAI versus oral antipsychotic medication use from January 1, 2017 to December 31, 2023.
    UNASSIGNED: There were N = 2685 LAI and N = 31 531 oral antipsychotic users. Being non-white (aOR = 1.3-2.0; P < .0001), non-female (aOR = 1.5; P < .0001), from a high deprivation neighborhood (NDI, aOR = 1.3; P < .0007), having a higher body mass index (BMI, aOR = 1.3-1.7; P < .0009), having a schizophrenia/schizoaffective (aOR = 5.8-6.8; P < .0001), psychotic (aOR = 1.6, P < .0001), or substance use disorder (aOR = 1.4; P < .0001), and outpatient psychiatry (aOR = 2.3-7.5; P < .0001) or inpatient hospitalization (aOR = 2.4; P < .0001) utilization in the prior year with higher odds and age ≥40 (aOR = 0.4-0.7; P < .0001) or bipolar disorder (aOR = 0.9; P < .05) were associated with lower odds of LAI use. Non-white, non-female, age 18-39, and high NDI patients had higher LAI use regardless of treatment adherence markers. Smoking and cardiometabolic markers were also associated with LAI use.
    UNASSIGNED: Demographic and clinical factors are associated with increased LAI use irrespective of treatment adherence. Research on utilization variation informing equitable formulation use aligned with treatment guideline recommendations is warranted.
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  • 文章类型: Journal Article
    本系统综述旨在找到能最好地预测乳糜泻个体坚持无麸质饮食(GFD)的工具。用于个体预后或诊断的多变量预测模型的透明报告(TRIPOD-SRMA)指南用于构建和收集来自八个科学数据库(PubMed,EMBASE,LILACS,WebofScience,LIVIVIVO,Scopus,谷歌学者,和Proquest),2023年11月16日。纳入标准是涉及18岁以上的乳糜泻(CD)患者并接受GFD至少六个月的研究。使用问卷来预测对GFD的依从性,并将其与实验室测试(血清学测试,谷蛋白免疫原性肽-GIP,或活检)。评论文章,书籍章节,没有足够数据的研究被排除.预测建模研究系统评价的关键评估和数据提取清单(CHARMS)用于从选定的主要研究中收集数据,并使用偏见风险预测评估工具(PROBAST)评估他们的偏见风险和质量。使用phi应急系数评估由工具确定的GFD依从性与实验室测试之间的关联。这篇综述中包含的研究使用了四种不同的工具来评估GFD依从性:BIAGI评分,腹腔膳食粘附试验(CDAT),自我报告问题,和采访。最常用的比较方法是活检(n=19;59.3%),其次是血清学(n=14;43.7%)和谷蛋白免疫原性肽(GIPs)(n=4;12.5%)。面试之间没有显着差异,自我报告,和用于评估GFD依从性的BIAGI工具。与CDAT相比,这些工具与GFD依从性的相关性更好。考虑到他们的成本,申请时间,和预测能力,自我报告和BIAGI是评估GFD依从性的首选工具.
    This systematic review aimed to find the tool that best predicts celiac individuals\' adherence to a gluten-free diet (GFD). The Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis (TRIPOD-SRMA) guideline was used for the construction and collection of data from eight scientific databases (PubMed, EMBASE, LILACS, Web of Science, LIVIVO, SCOPUS, Google Scholar, and Proquest) on 16 November 2023. The inclusion criteria were studies involving individuals with celiac disease (CD) who were over 18 years old and on a GFD for at least six months, using a questionnaire to predict adherence to a GFD, and comparing it with laboratory tests (serological tests, gluten immunogenic peptide-GIP, or biopsy). Review articles, book chapters, and studies without sufficient data were excluded. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) was used for data collection from the selected primary studies, and their risk of bias and quality was assessed using the Prediction Risk of Bias Assessment Tool (PROBAST). The association between the GFD adherence determined by the tool and laboratory test was assessed using the phi contingency coefficient. The studies included in this review used four different tools to evaluate GFD adherence: BIAGI score, Coeliac Dietary Adherence Test (CDAT), self-report questions, and interviews. The comparison method most often used was biopsy (n = 19; 59.3%), followed by serology (n = 14; 43.7%) and gluten immunogenic peptides (GIPs) (n = 4; 12.5%). There were no significant differences between the interview, self-report, and BIAGI tools used to evaluate GFD adherence. These tools were better associated with GFD adherence than the CDAT. Considering their cost, application time, and prediction capacity, the self-report and BIAGI were the preferred tools for evaluating GFD adherence.
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