Prescription Patterns for Pulmonary Vasodilators in the Treatment of Pulmonary Hypertension Associated With Chronic Lung Diseases: Insights From a Clinician Survey.
Prescription Patterns for Pulmonary Vasodilators in the Treatment of Pulmonary Hypertension Associated With Chronic Lung Diseases: Insights From a Clinician Survey.
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DOI：
10.3389/fmed.2021.764815
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发表时间：
2021
影响因子：
3.9
通讯作者：
de Jesus Perez V
中科院分区：
文献类型：
--
作者：
Thomas CA;Lee J;Bernardo RJ;Anderson RJ;Glinskii V;Sung YK;Kudelko K;Hedlin H;Sweatt A;Kawut SM;Raj R;Zamanian RT;de Jesus Perez V
背景：肺动脉高压是慢性肺病(PH-CLD)的一种并发症，具有很高的发病率和死亡率。PH-CLD的管理指南强调对潜在肺部疾病的治疗，但PH靶向治疗的作用仍然存在争议。我们假设，根据CLD的类型和PH的严重程度，不同的医生对PH-CLD的治疗方法是不同的。方法和结果：在2020年5月至7月期间，我们对PH专家进行了一项在线调查，询问他们对7个不同严重程度的PH-CLD假设性病例的首选治疗方法。我们使用Fleiss的kappa计算评估了临床医生对初始治疗选择的一致意见。超过90%的受访者同意，他们会在轻度肺部疾病的情况下，通过某种形式的肺高压靶向治疗来治疗重度肺高压。对于有严重肺部疾病的重度PH患者，超过70%的受访者同意使用PH靶向治疗。对于轻度肺高压和轻度肺部疾病，50%的受访者选择开始针对肺高压的治疗。在所有病例中，受访者在选择使用单一、双重或三重联合疗法与PH特异性药物的问题上总体上意见不一致。结论：尽管管理指南不鼓励常规使用PH靶向治疗来治疗PH-CLD患者，但大多数医生选择使用某种形式的PH靶向治疗。治疗的选择和治疗方法是不同的，似乎受到PH的严重程度和潜在的肺部疾病的影响。
Background: Pulmonary hypertension is a complication of chronic lung diseases (PH-CLD) associated with significant morbidity and mortality. Management guidelines for PH-CLD emphasize the treatment of the underlying lung disease, but the role of PH-targeted therapy remains controversial. We hypothesized that treatment approaches for PH-CLD would be variable across physicians depending on the type of CLD and the severity of PH. Methods and Results: Between May and July 2020, we conducted an online survey of PH experts asking for their preferred treatment approach in seven hypothetical cases of PH-CLD of varying severity. We assessed agreement amongst clinicians for initial therapy choice using Fleiss' kappa calculations. Over 90% of respondents agreed that they would treat cases of severe PH in the context of mild lung disease with some form of PH-targeted therapy. For cases of severe PH in the context of severe lung disease, over 70% of respondents agreed to use PH-targeted therapy. For mild PH and mild lung disease cases, <50% of respondents chose to start PH-specific therapy. There was overall poor agreement between respondents in the choice to use mono-, double or triple combination therapy with PH-specific agents in all cases. Conclusion: Although management guidelines discourage the routine use of PH-targeted therapies to treat PH-CLD patients, most physicians choose to treat patients with some form of PH-targeted therapy. The choice of therapy and treatment approach are variable and appear to be influenced by the severity of the PH and the underlying lung disease.
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影响因子：
2.6
作者：
Bajwa, Abubakr A.;Shujaat, Adil;Burger, Charles D.
通讯作者：
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