Rapid Change in Prescribing Behavior in Hospitals Participating in Get With The Guidelines-Stroke After Release of the Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) Clinical Trial Results
Rapid Change in Prescribing Behavior in Hospitals Participating in Get With The Guidelines-Stroke After Release of the Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) Clinical Trial Results
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DOI：
10.1161/strokeaha.110.584151
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发表时间：
2010-09-01
期刊：
影响因子：
8.3
通讯作者：
Smith, Eric E.
中科院分区：
文献类型：
--
作者：
Menon, Bijoy K.;Frankel, Michael R.;Smith, Eric E.
背景和目的-尽管发表了随机试验和共识指南，医生的处方模式改变缓慢。我们在GWTG-卒中计划GET试验中测量氯吡格雷治疗高危患者动脉粥样硬化血栓形成(Match)对卒中患者和短暂性脑缺血发作患者出院处方模式的影响。方法：分析2002年10月至2006年1月参加GWTG-卒中的医院收治的缺血性卒中或短暂性脑缺血发作患者的出院抗血栓药物处方模式。临床信息按季度进行分析，并与Match研究的发表相关。对阿司匹林+氯吡格雷赛后公布的出院处方频率与赛前进行比较。结果：共有632个部位的107 872名患者在出院时接受抗血栓治疗。在Match出版后，使用阿司匹林+氯吡格雷治疗的患者从22.4%下降到15.4%(调整后的OR为0.62，95%CI为0.56至0.70，P
Background and Purpose-Physician prescribing patterns change slowly despite published randomized trials and consensus guidelines. We measure the effect of Management of Atherothrombosis With Clopidogrel in High-Risk Patients (MATCH) trial on discharge prescribing patterns for patients with stroke and those with transient ischemic attack in the Get With The Guidelines (GWTG)-Stroke Program.Methods-We analyzed discharge prescribing patterns of antithrombotic medications for patients admitted with ischemic stroke or transient ischemic attack at hospitals participating in GWTG-Stroke between October 2002 to January 2006. Clinical information by quarter was analyzed in relation to publication of the MATCH study. Frequency of discharge prescription of aspirin+clopidogrel post-MATCH publication was compared with the pre-MATCH period after adjusting for patient and hospital characteristics and clustering by hospital.Results-A total of 107 872 patients at 632 sites were eligible to receive antithrombotic therapy at discharge. Use of aspirin+clopidogrel therapy declined from 22.4% to 15.4% of patients after the publication of MATCH (adjusted OR 0.62, 95% CI 0.56 to 0.70, P