Reconciling Between Medication Orders and Medication Fills for Lupus in Pregnancy.
Reconciling Between Medication Orders and Medication Fills for Lupus in Pregnancy.
复制标题
DOI：
10.1002/acr2.11501
复制
发表时间：
2022-12
影响因子：
3.4
通讯作者：
Hedderson, Monique M.
中科院分区：
文献类型：
--
作者：
Simard, Julia F.;Liu, Emily F.;Chakravarty, Eliza;Rector, Amadeia;Cantu, Miranda;Kuo, Daniel Z.;Shaw, Gary M.;Druzin, Maurice;Weisman, Michael H.;Hedderson, Monique M.
大多数研究认为药物是有序的或填充的，但不是两者兼而有之。基于填写数据的药物使用不足不一定归因于患者不依从。使用这两种数据来源，我们量化了一组普遍存在的系统性红斑狼疮（SLE）妊娠患者的主要药物依从性。我们在2011年至2020年期间在Kaiser Permanente北方加州的SLE患者中确定了419例妊娠。我们计算了怀孕期间医生发起的订单或药房发起的重新订单的数量以及前一年（怀孕前）9个月的可比窗口，以及羟基氯喹（HCQ），硫唑嘌呤和皮质类固醇的订单比例和30天内的订单比例。对于未订购或重新订购的妊娠，我们确定了既往处方填充重叠进入相应研究阶段的比例。狼疮药物的新订单通常都是满的。HCQ是最常见的处方（45.8%的妊娠），通常填充（89.7%在妊娠前，93.2%在妊娠期间）。大多数在30天内填充（80.5%妊娠前，83.3%妊娠）。一些没有新的HCQ订单的孕妇从以前的订单中连续补充; 2011-2015年的孕妇中有53%有新的订单或以前的填充覆盖范围，而2016-2019年的孕妇为63.2%。孕前和孕期皮质类固醇填充率分别为90.6%和83.6%。使用硫唑嘌呤的患者较少;然而，大多数新订单都得到了满足（94.3%为孕前，91.7%为妊娠）。对于硫唑嘌呤和皮质类固醇，孕前的填充率略高于妊娠期。我们观察到，患者在怀孕期间对狼疮药物（如HCQ和硫唑嘌呤）的新订单有很高的依从性。
Most studies consider either medications ordered or filled, but not both. Medication underuse based on filling data cannot necessarily be ascribed to patient nonadherence. Using both data sources, we quantified primary medication adherence in a cohort of prevalent systemic lupus erythematosus (SLE) pregnancies. We identified 419 pregnancies in Kaiser Permanente Northern California in patients with prevalent SLE from 2011 to 2020. We calculated the number of physician‐initiated orders or pharmacy‐initiated reorders during pregnancy and a comparable 9‐month window the year before (prepregnancy) and the proportion of orders ever filled and filled within 30 days for hydroxychloroquine (HCQ), azathioprine, and corticosteroids. For pregnancies without an order or reorder, we identified the proportion with previous prescription fills overlapping into the respective study period. New orders for lupus medications were usually filled. HCQ was prescribed most often (45.8% pregnancies) and usually filled (89.7% in prepregnancy, 93.2% during pregnancy). The majority filled within 30 days (80.5% prepregnancy, 83.3% pregnancy). Some pregnancies without new HCQ orders had continuous refills from prior orders; 53% of 2011–2015 pregnancies either had a new order or fill coverage from a previous period, compared to 63.2% of pregnancies delivering in 2016–2019. Corticosteroid fill frequencies were 90.6% in prepregnancy and 83.6% during pregnancy. Fewer patients used azathioprine; however, most new orders were filled (94.3% prepregnancy, 91.7% pregnancy). For azathioprine and corticosteroids, fill rates were modestly higher in prepregnancy compared to pregnancy. We observed that patients have high adherence to filling new orders for lupus medications, such as HCQ and azathioprine, in pregnancy.
登录
查看更多内容
影响因子：
4.7
作者：
Feldman, Candace H.;Collins, Jamie;Costenbader, Karen H.
通讯作者：
Costenbader, Karen H.
影响因子：
3.9
作者：
Liu, Lucy H.;Fevrier, Helene B.;Herrinton, Lisa J.
通讯作者：
Herrinton, Lisa J.
系统性红斑狼疮不良妊娠结局的高危因素：中国人群的回顾性研究
影响因子：
2.9
作者：
Jiang M;Chang Y;Wang Y;Fu Q;Lin S;Wu J;Di W
通讯作者：
Di W
影响因子：
27.4
作者：
Andreoli L;Bertsias GK;Agmon-Levin N;Brown S;Cervera R;Costedoat-Chalumeau N;Doria A;Fischer-Betz R;Forger F;Moraes-Fontes MF;Khamashta M;King J;Lojacono A;Marchiori F;Meroni PL;Mosca M;Motta M;Ostensen M;Pamfil C;Raio L;Schneider M;Svenungsson E;Tektonidou M;Yavuz S;Boumpas D;Tincani A
通讯作者：
Tincani A
影响因子：
2.4
作者：
Petri, M.;Daly, R. P.;Pushparajah, D. S.
通讯作者：
Pushparajah, D. S.