检索结果-内蒙古大学图书馆

Determinants of angiotensin-converting enzyme inhibitor prescription in severe heart failure with left ventricular systolic dysfunction:: The EPICAL study

引用

AMERICAN HEART JOURNAL 2000年第4期139卷 624-631页

作者： Echemann, M Zannad, F Briançon, S Juillière, Y Mertès, PM Virion, JM Villemot, JP CHU CIC INSERM F-54035 Nancy France Hop Marin Serv Epidemiol & Evaluat Clin Nancy France Univ Henri Poincare Fac Med Pharmacol Clin Lorraine France

Background Angiotensin-converting enzyme (ACE) inhibitors have been demonstrated to reduce morbidity and mortality rates in patients with heart failure with left ventricular systolic dysfunction. Nevertheless, these drugs are underutilized in current practice and prescribed at doses below those usually recommended. The aim of this work was to identify the social, demographic, laboratory, clinical, and therapeutic factors associated with nonprescription of ACE inhibitors and/or their prescription at doses below those recommended in the treatment of severe long-term congestive heart failure (CHF). Methods and Results An epidemiologic observational study, EPICAL (EPidemiologie de l'Insuffisance Cardiaque Avancee en Lorraine), studied 417 patients with severe CHF surviving after the index hospitalization. Multivariate logistic regression determined the factors associated with ACE inhibitor nonprescription and with their prescription at lower-than-recommended doses. ACE inhibitors were taken by 75% of the patients but 38% took lower-than-recommended doses. Factors shown to be associated with nonprescription included patients >65 years of age with renal impairment (odds ratio 19.5, confidence interval [CI] 7.9-48.0), nonsinus cardiac rhythm (odds ratio 2.0, CI 1.2-3.2), and prescription of potassium-sparing diuretics (odds ratio 2.4, CI 1.2-4.7). Renal impairment was the single most important factor associated with prescription of lower-than-recommended doses, particularly in elderly patients. Conclusions Our results underline the need for optimal and better use of ACE inhibitor therapy. CHF treatment guidelines must be more uniformly applied by all physicians caring for patients with heart failure.

关键词：慢性病剂量效应关系药物用药计划表药物利用/统计学和数值数据法国肾功能试验处方药物/统计学和数值数据前瞻性研究心缩期/药物作用心室功能障碍左/诊断心室功能障碍左/药物疗法女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Changes in rates of β-blocker use between 1994 and 1997 among elderly survivors of acute myocardial infarction

引用

AMERICAN HEART JOURNAL 2000年第4期140卷 663-671页

作者： Heller, DA Ahern, FM Kozak, M Penn State Univ Dept Biobehav Hlth University Pk PA 16802 USA Penn State Univ Hlth Serv 1 PACE Program Harrisburg PA USA Penn State Univ Milton S Hershey Med Ctr Coll Med Dept MedDiv Cardiol Hershey PA 17033 USA

Background Results of recent studies suggest that beta-biockers are underused by elderly acute myocardial infarction (AMI) survivors. The goals of this study were to examine changes in post-AMI beta-blocker use occurring between 1994 and 1997 and to identify factors associated with outpatient use of beta-blockers. Methods Patients included 9534 individuals greater than or equal to 65 years of age who were enrolled in Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) and who survived AMI between 1994 and 1997. With the use of outpatient prescription claims, beta-blocker usage rates were examined by year, and multivariate logistic regression was used to identify predictors of beta-blocker use. Results Post-AMI beta-blocker use increased from 39.6% in 1994 to 58.6% in 1997. Controlling for AMI year, individuals who had any prescriptions written by a cardiologist were more likely to use a beta-blocker than individuals who received all prescriptions from noncardiologists (odds ratio 1.52, P = .0001). Elderly patients who did not use beta-blockers tended to have greater severity of illness, non-Q-wave infarctions, atrial fibrillation, and comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, and asthma. Use of calcium channel blockers and diuretics was negatively associated with beta-blocker use, but persons using lipid-lowering agents were more likely to use beta-blockers. Conclusions Significant improvements in beta-blocker use by elderly AMI survivors have occurred since 1994. Differences among physician specialties in beta-blocker prescribing appear to remain. Across all prescriber specialities, historic contraindications constitute major factors in the choice of post-AM I therapy. Further efforts should be made to encourage the use of beta-blockers in elderly survivors of AMI, particularly those with heart failure.

关键词：肾上腺素能β受体拮抗剂/治疗应用猝死心脏/预防和控制心电描记术/药物作用随访研究心率/药物作用心率/生理学心肌梗死/药物疗法心肌梗死/死亡率心肌梗死/病理生理学比值比门诊病人宾夕法尼亚/流行病学处方药物/统计学和数值数据预后回顾性研究存活率/发展趋势老年人老年人 80以上女(雌)性人类男(雄)性

来源：评论

学校读者我要写书评

暂无评论

Utilization of common analgesic and anxiolytic medications by registered first nations residents of western Canada

引用

SUBSTANCE USE & MISUSE 2000年第4期35卷 601-616页

作者： Anderson, JF McEwan, KL British Columbia Minist Hlth Community Hlth Programs Clin Support Unit Victoria BC V8W 3C8 Canada Minist Responsible Seniors Victoria BC V8W 3C8 Canada Univ Victoria Dept Psychol Victoria BC Canada

The study examined utilization of acetaminophen with codeine and benzodiazepine drugs among Non-Insured Health Benefits (NIHB) program registered First Nations residents in the four western provinces of Canada and sought preliminary indicators of factors influencing utilization. A small percentage of NIHB clients in the four western provinces were excessive users of acetaminophen with codeine and/or benzodiazepines, but overall utilization of these central nervous system drugs was moderate and within the bounds of non-First Nations population use examined in this study. The study also demonstrated that utilization of acetaminophen with codeine among NIHB claimants was inversely related to the stringency of provincial regulation.

关键词：处方药物/统计学和数值数据萨斯喀彻温

来源：评论

学校读者我要写书评

暂无评论

Risk of resistance related to antibiotic use before admission in patients with community-acquired bacteraemia

引用

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 1999年第1期43卷 119-126页

作者： Pedersen, G Schonheyder, HC Steffensen, FH Sorensen, HT Aalborg Hosp Dept Med M Aalborg Denmark Aalborg Hosp Dept Clin Microbiol Aalborg Denmark Univ Aarhus Danish Epidemiol Sci Ctr Dept Epidemiol & Social Med Aarhus Denmark Aarhus Univ Hosp Dept Med 5 Aarhus Denmark

We analysed the association of antibiotic therapy before admission and antibiotic resistance of blood isolates in a total of 1717 community-acquired bacteraemias in the County of Northern Jutland during 1992-96. Antibiotics had been prescribed to 14% of the patients during the 30 days before admission and to 37% during the 6 months. The most frequently prescribed antibiotics within 30 days were ampicillin (28%), penicillin G (27%), sulphonamides and/or trimethoprim (16%) and macrolides (14%). The most frequent blood isolates were Escherichia coli (33%), other Enterobacteriaceae (8%), Streptococcus pneumoniae (23%) and Staphylococcus aureus (10%). Of the 575 isolates of E. coli, 425 (74%), 432 (75%) and 518 (90%) were susceptible to ampicillin, sulphonamides and trimethoprim, respectively. Previous antibiotic prescriptions were strongly associated with resistance to ampicillin, sulphonamides and trimethoprim in E. coli. The association was less pronounced for S. aureus and enteric rods other than E. coli. Antibiotic prescriptions within the last 3 months predicted antibiotic resistance, and this should be taken into account when selecting empirical antibiotic therapy of severe community-acquired infections.

关键词：氨苄西林/药理学氨苄西林/治疗应用抗菌药/药理学抗菌药/治疗应用菌血症/药物疗法菌血症/流行病学菌血症/微生物学社区获得性感染/药物疗法社区获得性感染/流行病学社区获得性感染/微生物学丹麦抗药性微生物药物利用/统计学和数值数据肠杆菌科/药物作用大肠杆菌/药物作用试验预期值处方药物/统计学和数值数据葡萄球菌金黄色/药物作用甲氧苄啶/药理学甲氧苄啶/治疗应用老年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

引用

AMERICAN JOURNAL OF MEDICINE 2000年第6期109卷 489-492页

作者： Shah, MR Granger, CB Bart, BA McMurray, JJV Petrie, MC Michelson, EL Tudor, CE Swedberg, K Stevenson, LW Califf, RM Pfeffer, MA Duke Clin Res Inst Durham NC 27715 USA Univ Glasgow Glasgow Lanark Scotland AstraZeneca LP Wayne PA USA Sahlgrens Univ Hosp S-41345 Gothenburg Sweden Brigham & Womens Hosp Boston MA 02115 USA

An important step in understanding whether heart failure affects men and women differently is to define the clinical characteristics and patterns of treatment in women with this disease (1,2). We reviewed the Study of Patients Intolerant of Converting Enzyme inhibitors (SPICE) registry, a large registry of patients with left ventricular systolic dysfunction, to describe the clinical features and trends in medication use in women. We also sought to identify any differences between the sexes in the use of angiotensin-converting enzyme (ACE) inhibitors, diuretics, and other heart-failure *** important step in understanding whether heart failure affects men and women differently is to define the clinical characteristics and patterns of treatment in women with this disease (1,2). We reviewed the Study of Patients Intolerant of Converting Enzyme inhibitors (SPICE) registry, a large registry of patients with left ventricular systolic dysfunction, to describe the clinical features and trends in medication use in women. We also sought to identify any differences between the sexes in the use of angiotensin-converting enzyme (ACE) inhibitors, diuretics, and other heart-failure medications.

关键词：血压心血管药物/治疗应用利尿药/投药和剂量处方药物/统计学和数值数据登记疾病严重程度指数性别因素心缩期心室功能障碍左/药物疗法心室功能障碍左/病因学心室功能障碍左/病理生理学女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Rationality of drug prescriptions in rural health centres in Burkina Faso

引用

HEALTH POLICY AND PLANNING 1999年第3期14卷 291-298页

作者： Krause, G Borchert, M Benzler, J Heinmüller, R Kaba, I Savadogo, M Siho, N Diesfeld, HJ Univ Heidelberg Inst Trop Hyg & Publ Hlth ITHOG D-6900 Heidelberg Germany Deutsch Entwicklungsdienst DED Nouna Burkina Faso Serv Sante PRAPASS Projet Rech Act Ameliorat Nouna Burkina Faso

The objective of this study is to investigate the quality of drug prescriptions in nine health centres of three districts in rural Burkina Faso. 313 outpatient consultations were studied by methods of guided observation. Additionally interviews were held with the health care workers involved in the study. A total of 793 drugs prescribed by 15 health care workers during the observation period and 2815 prescribed drugs copied from the patient register were analyzed. An average of 2.3 drugs were prescribed per visit. 88.0% of the prescribed drugs were on the essential drug list. 88.4% were indicated according to the national treatment guidelines. 79.4% had a correct dosage. The study revealed serious deficiencies in drug prescribing that could not be detected by assessing selected quantitative drug-use indicators as recommended by the WHO. In two-thirds of the cases the patients received no information on how long the drug had to be taken. Errors in dosage occurred significantly more often in children under 5 years. The combined analysis of choice and dosage of drugs showed that 59.3% of all the patients received a correct prescription. Seven out of 21 pregnant women received drugs contraindicated in pregnancy. We conclude that assessment of quantitative drug-use indicators alone does not suffice in identifying specific needs for improvement in treatment quality. We recommend that prescribing for children under 5 and for pregnant women should be targeted in future interventions and that the lay-out, content and distribution of treatment guidelines must be improved.

关键词：医务工作者的态度布基纳法索药物利用/标准评价研究卫生服务研究病人依从处方药物/统计学和数值数据卫生保健质量乡村卫生服务/组织和管理乡村卫生服务/标准女(雌)性人类妊娠

来源：评论

学校读者我要写书评

暂无评论

Use of cholesterol-lowering medications in the United States from 1991 to 1997

引用

AMERICAN JOURNAL OF MEDICINE 2000年第6期108卷 496-499页

作者： Siegel, D Lopez, J Meier, J NCHCS Dept Vet Affairs Med Serv 111 Mather CA 95655 USA Univ Calif Davis Dept Med Davis CA 95616 USA NCHCS Dept Vet Affairs Serv Pharm Martinez CA 95655 USA Univ Pacific Sch Pharm Stockton CA 95211 USA

The benefits of cholesterol-lowering medication in hypercholesterolemic patients was first suggested by the long-term follow-up of the Coronary Drug Project, which studied the use of niacin in men with previous myocardial infarction (1). Since that study, several secondary prevention trials using different 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have found even greater benefit in these patients (2,3), including men and women with average serum cholesterol levels (4). Benefits have also been shown in a primary prevention trial among men with hypercholesterolemia (5). In 1988, the National Cholesterol Education Program (NCEP) issued recommendations for the detection and control of hypercholesterolemia (6). Subsequently, there has been increased use of cholesterol-lowering medications (7,8), although several studies indicate that these drugs are underutilized (9–11).

关键词：处方药物/经济学处方药物/统计学和数值数据美国

来源：评论

学校读者我要写书评

暂无评论

Effect of a drug supply and cost sharing system on prescribing and utilization: A controlled trial from Nepal

引用

HEALTH POLICY AND PLANNING 1995年第4期10卷 423-430页

作者： Chalker, J SAVE CHILDREN FUND HANOIVIETNAM

The effect on prescribing habits of a drug supply and cost sharing system was studied in a hill district in Nepal. In this district the inadequate yearly supply of drugs from the government was supplemented by an extra supply from the project. Drugs were sold at a fixed prescription charge which covered all drugs for one episode of illness. The prescribing pattern in this district was compared to a control district with only the yearly government drug supply and no drug scheme. Drugs prescribed were also compared to theoretical needs based on the recorded diagnoses of the same patients and recommended treatment guidelines. Attendance figures were studied before and after the introduction of the drug scheme in the test district. A 25% sample of prescriptions was taken from all health posts in both districts, over a one year period. This was in total 11 772 prescriptions from 22 health posts. The results show that in the drug scheme district health workers prescribed essential drugs excessively. However, the doses that were prescribed were somewhat better than in the control district. Utilization of health facilities dropped by 18% in the drug scheme district and then increased in the second year. A supply of essential drugs does not necessarily improve the quality of care, or increase attendance levels. The WHO indicators designed to assess the quality of drug use at health facilities can give a misleading picture, as they do not include information on dosages. The effect on quality of care of supply and financing mechanisms needs further study.

关键词：费用分担发展中国家药物利用评审/经济学药物利用评审/标准药物利用评审/统计学和数值数据费用药物/统计学和数值数据卫生服务滥用尼泊尔药用制剂/经济学药用制剂/供应和分配医师诊疗模式/统计学和数值数据卫生保健质量/统计学和数值数据回顾性研究世界卫生组织青少年成年人儿童学龄前人类婴儿婴儿新生

来源：评论

学校读者我要写书评

暂无评论

Are stimulants overprescribed?

引用

JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY 2000年第3期39卷 269-270页

作者： Perry, R Gilbert, EM Angkustsiri, K Bellevue Hosp Ctr New York NY 10016 USA

来源：评论

学校读者我要写书评

暂无评论

Prescribing practices of advanced practice psychiatric nurses: Part I - Demographic, educational, and practice characteristics

引用

ARCHIVES OF PSYCHIATRIC NURSING 2001年第5期15卷 205-213页

作者： Talley, S Richens, S YaleUniversitySchoolofNursing 100ChurchStreetSouthNewHavenCT06536-0740USA.Sandra.talley@yale.edu

This study was designed to identify and describe the prescribing practices of advanced practice psychiatric nurses. Part I describes the demographic, educational, and clinical setting characteristics. A survey method was used with N = 88 nurses representing seven different states. Nurse prescribers were: younger than nonprescribers, employed in community mental health settings, and voluntarily using a consulting physician arrangement. Limitations on practice included: statute formulary, controlled substances, and formulary/protocols with a consulting physician. Results suggest nurses' prescribing practices are used in outpatient settings, viewed as conservative, with a value on physician collaboration even in the absence of legal mandates. Copyright (C) 2001 by W.B. Saunders Company.

关键词：年龄因素门诊医疗/统计学和数值数据药物利用评审教育程度就业/统计学和数值数据临床护理医生/教育临床护理医生/组织和管理开业护士/教育开业护士/组织和管理护理评价研究医师诊疗模式处方药物/统计学和数值数据职业自主权精神病护理学/教育精神病护理学/组织和管理问卷调查转诊和会诊/统计学和数值数据美国成年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：