Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta-analysis.
Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta-analysis.
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中风幸存者的抗血栓处方和依从性：系统评价和荟萃分析
DOI：
10.1002/brb3.2752
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发表时间：
2022-10
影响因子：
3.1
通讯作者：
Yang J
中科院分区：
文献类型：
--
作者：
Yang M;Cheng H;Wang X;Ouyang M;Shajahan S;Carcel C;Anderson C;Kristoffersen ES;Lin Y;Sandset EC;Wang X;Yang J
我们的目的是调查中风后抗血栓药物（包括抗凝剂和抗血小板药物）的处方和用药依从性。我们在MEDLINE和Embase中进行了一次系统性文献检索，检索时间为2015年1月1日至2022年2月17日，以识别报告卒中后抗血栓药物（抗凝剂和抗血小板药物）的研究。两个人独立地确定报告包括，提取数据，并根据Newcastle-Ottawa量表评估纳入研究的质量。在可能的情况下，使用随机效应Meta分析汇总数据。我们纳入了来自46项研究的453，625例卒中患者。房颤（AF）患者中处方抗血小板药和抗凝药的汇总比例分别为62%（95% CI：57%-68%）和68%（95% CI：58%-79%）。根据4项研究中抗血栓药物指南的建议接受治疗的患者的汇总比例为67%（95% CI：41%-93%）。据报告，11%（95% CI：2%-19%）的患者未接受抗血栓药物治疗。抗血小板、抗凝剂和抗血栓药物的良好依从性分别为78%（95% CI：67%-89%）、71%（95% CI：57%-84%）和73%（95% CI：59%-86%）。总之，我们发现不到70%的患者根据抗血栓药物的推荐指南进行处方和治疗，并且对抗血栓药物的良好依从性仅为73%。在卒中幸存者中，处方率和抗血栓药物的良好依从性仍需提高。
We aimed to investigate the prescription of antithrombotic drugs (including anticoagulants and antiplatelets) and medication adherence after stroke. We performed a systematic literature search across MEDLINE and Embase, from January 1, 2015, to February 17, 2022, to identify studies reporting antithrombotic medications (anticoagulants and antiplatelets) post stroke. Two people independently identified reports to include, extracted data, and assessed the quality of included studies according to the Newcastle–Ottawa scale. Where possible, data were pooled using random‐effects meta‐analysis. We included 453,625 stroke patients from 46 studies. The pooled proportion of prescribed antiplatelets and anticoagulants among patients with atrial fibrillation (AF) was 62% (95% CI: 57%–68%), and 68% (95% CI: 58%–79%), respectively. The pooled proportion of patients who were treated according to the recommendation of guidelines of antithrombotic medications from four studies was 67% (95% CI: 41%–93%). It was reported that 11% (95% CI: 2%–19%) of patients did not receive antithrombotic medications. Good adherence to antiplatelet, anticoagulant, and antithrombotic medications was 78% (95% CI: 67%–89%), 71% (95% CI: 57%–84%), and 73% (95% CI: 59%–86%), respectively. In conclusion, we found that less than 70% of patients were prescribed and treated according to the recommended guidelines of antithrombotic medications, and good adherence to antithrombotic medications is only 73%. Prescription rate and good adherence to antithrombotic medications still need to be improved among stroke survivors.
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