Chronic obstructive pulmonary disease hospital admissions and drugs--unexpected positive associations: a retrospective general practice cohort study.
Chronic obstructive pulmonary disease hospital admissions and drugs--unexpected positive associations: a retrospective general practice cohort study.
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DOI：
10.1038/npjpcrm.2014.6
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发表时间：
2014-05-20
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
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用于治疗慢性阻塞性肺疾病的吸入型长效抗毒鼠药(LAMA)和联合吸入型长效β-2激动剂和皮质类固醇(LABA+ICS)药物的处方增加，这使人们对减少这种疾病的住院人数产生了希望。目的探讨初级保健处方使用LAMA和LABA+ICS药物对COPD患者入院情况的影响。这项关于2007至2010年间全科COPD入院和处方数据的回溯性队列研究由806名具有代表性的英国全科医生(人口5264,506)组成。结果指标为慢性阻塞性肺疾病患者入院实施率和LAMA和LABA+ICS的处方费用。全科医学的特点是基于英国的质量和成果框架。从2001年到2010年，慢性阻塞性肺病的入院率保持稳定。2007年至2010年，每个实习患者开出的LAMA量和每个实习患者的LABA+ICS分别增加了61%和26%。LAMA与LABA+ICS费用的相关性逐年上升，2010年最高(皮尔逊相关系数r=0.68；95%可信区间0.64~0.72)。在控制执业清单大小、COPD患病率和剥夺时，LAMA(2010：B=1.23，95%CI，0.61-1.85)和LABA+ICS(2010：B=0.32，95%CI，0.12-0.52)对执业COPD入院率有正向预测作用。LAMA和LABA+ICS吸入器处方的增加与COPD患者住院率的预期下降无关。未解释高实践COPD处方与高实践COPD入院之间的正相关关系。
Increased prescribing of inhaled long-acting anti-muscarinic (LAMA) and combined inhaled long-acting β2-agonist and corticosteroid (LABA+ICS) drugs for the treatment of chronic obstructive pulmonary disease (COPD) has led to hopes of reduced hospital admissions from this disease. To investigate the impact of rising primary care prescribing of LAMA and LABA+ICS drugs on COPD admissions. This retrospective cohort study of general practice COPD admission and prescribing data between 2007 and 2010 comprised a representative group of 806 English general practices (population 5,264,506). Outcome measures were practice rates of COPD patient admissions and prescription costs of LAMA and LABA+ICS. General practice characteristics were based on the UK quality and outcomes framework. Rates of COPD admissions remained stable from 2001 to 2010. Practice-prescribing volumes of LAMA per practice patient and LABA+ICS per practice patient increased by 61 and 26%, respectively, between 2007 and 2010. Correlation between costs of LAMA and those of LABA+ICS increased year on year, and was the highest in 2010 (Pearson’s r=0.68; 95% confidence interval (CI), 0.64–0.72). Practice COPD admission rates were positively predicted by practice-prescribing volumes of LAMA (2010: B=1.23, 95% CI, 0.61–1.85) and of LABA+ICS (2010: B=0.32, 95% CI, 0.12–0.52) when controlling for practice list size, COPD prevalence and deprivation. The increase in the prescribing of LAMA and LABA+ICS inhalers was not associated with the predicted fall in hospital admission rates for COPD patients. The positive correlation between high practice COPD prescribing and high practice COPD admissions was not explained.
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影响因子：
168.9
作者：
Calverley, P;Pauwels, R;Maden, C
通讯作者：
Maden, C
DOI：
10.1164/rccm.200707-973oc
发表时间：
2008-01-01
影响因子：
24.7
作者：
Wedzicha, Jadwiga A.;Calverley, Peter M. A.;Stockley, Robert A.
通讯作者：
Stockley, Robert A.
影响因子：
2.4
作者：
Mauskopf, Josephine A;Baker, Christine L;Juniper, Melissa D
通讯作者：
Juniper, Melissa D
影响因子：
0.8
作者：
Kim, JH
通讯作者：
Kim, JH
影响因子：
8.4
作者：
Javier Nannini, Luis;Lasserson, Toby J.;Poole, Phillippa
通讯作者：
Poole, Phillippa