Evaluating ethnic differences in the prescription of NSAIDs for chronic kidney disease: a cross-sectional survey of patients in general practice
Evaluating ethnic differences in the prescription of NSAIDs for chronic kidney disease: a cross-sectional survey of patients in general practice
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DOI：
10.3399/bjgp14x680557
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发表时间：
2014-07-01
影响因子：
5.9
通讯作者：
Yaqoob, Muhammad Magdi
中科院分区：
文献类型：
--
作者：
Hull, Sally;Mathur, Rohini;Yaqoob, Muhammad Magdi
慢性肾脏病（CKD）和终末期肾脏病的公共卫生负担是国家优先考虑的问题，也是最近指南的主题。在英国，与白色人群（11%）相比，少数民族人群在肾脏替代人群中的比例过高（17.8%）。目的非甾体抗炎药（NSAID）是一种可预防的肾损伤原因。以前的研究表明，在CKD患者中，处方患病率在9%至36%之间，但没有研究种族组的差异。（阶段3-5）在Tower Hamlets、哈克尼和Newham的三个PCT中。使用描述性和多变量analysis.ResultsNSAIDs处方的CKD患者在2012年11月之前的一年中的11.1%。处方率随肾损害分期逐步下降。使用每日限定剂量，本研究表明，与白色组相比，南亚和黑人组均不太可能处于NSAID处方的前十分位，因此总体处方负荷将更小：（南亚人的比值比[OR]= 0.34，95%置信区间[CI] = 0.22至0.54，黑人组的OR = 0.34，95%CI = 0.19至0.63）。结论尽管长期以来人们对肾脏结果感到担忧，但全国非甾体抗炎药处方率仍在继续上升，非处方药销售仍未受到监测。处方模式表明，随着CKD的进展，全科医生会减少处方。不同种族人群对NSAID的不同使用不太可能导致少数民族人群中终末期肾病的高发生率。
BackgroundThe public health burden of chronic kidney disease (CKD) and end-stage kidney disease is a national priority and is the subject of recent guidelines. In the UK, ethnic minority groups are over-represented in the renal replacement population (17.8%) compared with the white population (11%).AimNon-steroidal anti-inflammatory drugs (NSAIDs) are a preventable cause of renal damage. Previous studies suggest a prescribing prevalence between 9% and 36% among those with CKD, but have not examined differences by ethnic group.Design and settingCross-sectional survey of 12 011 patients with identified CKD (stages 3-5) in the three PCTs of Tower Hamlets, Hackney, and Newham.MethodAssessment of NSAID prescribing rates in a multi-ethnic, socially-deprived population, using descriptive and multivariate analysis.ResultsNSAIDs were prescribed for 11.1% of patients with CKD in the year prior to November 2012. Prescribing rates decreased stepwise by stage of renal impairment. Using daily defined dosages this study shows that in comparison with white groups both South Asian and black groups are much less likely to be in the top decile of NSAID prescribing, hence the overall prescribing load will be less: (odds ratio [OR] for South Asians = 0.34, 95% confidence interval [CI] = 0.22 to 0.54, OR for black groups = 0.34, 95% CI = 0.19 to 0.63).ConclusionNational rates of NSAID prescribing continue to rise, and over-the-counter sales remain unmonitored, despite longstanding concerns about renal outcomes. Prescribing patterns indicate that GPs reduce prescribing as CKD progresses. Differential use of NSAIDs by ethnic group is unlikely to contribute to the high rates of end-stage kidney disease in ethnic minority groups.