Analysis of Medication Use Patterns: Apparent Overuse of Antibiotics and Underuse of Prescription Drugs for Asthma, Depression, and CHF
Analysis of Medication Use Patterns: Apparent Overuse of Antibiotics and Underuse of Prescription Drugs for Asthma, Depression, and CHF
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药物使用模式分析：治疗哮喘、抑郁症和慢性心力衰竭的抗生素明显过度使用，处方药使用不足
DOI：
10.18553/jmcp.2003.9.3.232
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
S. Isonaka
中科院分区：
文献类型：
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作者：
K. Gilberg;M. Laouri;S. Wade;S. Isonaka
注意事项：根据广泛接受的治疗指南评估处方药使用的适当性。方法：我们分析了1998年10月1日至1999年9月20日期间的行政索赔，由3个加州健康计划提供，以确定门诊处方的药物使用模式。我们将这些模式与在遵守治疗指南的情况下预期的模式进行了比较。研究结果：在研究期间，只有27.5%的抗抑郁药使用者接受了推荐的6个月连续治疗，只有49.0%的确诊哮喘患者接受了至少一种吸入性皮质类固醇处方（相比之下，67.1%的人接受了至少一种吸入性β受体激动剂处方），只有54.5%的充血性心力衰竭（CHF）患者接受了血管紧张素转换酶（ACE）抑制剂。在诊断为普通感冒或上呼吸道感染的患者中，35.7%接受了抗生素治疗。结论：有一个明显的过度使用和处方药使用不足的显着程度，尽管存在的临床指南，以支持在研究的条件下适当使用。有效的药物似乎未充分用于哮喘、CHF和抑郁症患者。抗生素似乎被过度用于普通感冒和上呼吸道感染。必须采取更有效的努力来解决药物的适当使用问题。没有这些努力，就不可能提高保健质量和降低保健系统总费用。
OBJECTIVES: To assess the appropriateness of prescription medication use based upon widely accepted treatment guidelines. METHODS: We analyzed administrative claims for the period October 1, 1998, through September 20, 1999, supplied by 3 California health plans to determine medication use patterns for outpatient prescriptions. We compared these patterns to those expected in the presence of adherence to treatment guidelines. RESULTS: During the study period, only 27.5% of antidepressant users received the recommended 6 months of continuous therapy, only 49.0% of diagnosed asthma patients received at least one inhaled corticosteroid prescription (compared to 67.1% who received at least one inhaled beta-agonist prescription), and only 54.5% of patients diagnosed with congestive heart failure (CHF) received an angiotensin-converting enzyme (ACE) inhibitor. Of patients who had a diagnosis of common cold or upper respiratory tract infection, 35.7% received antibiotics. CONCLUSIONS: There is a remarkable degree of apparent overuse and underuse of prescription medications despite the existence of clinical guidelines to support appropriate use in the conditions studied. Effective medications appear to be underused for patients with asthma, CHF, and depression. Antibiotics appear to be overused for the common cold and upper respiratory infections. More effective efforts must be made to address appropriate use of medications. Without these efforts, improved quality of care and decreased total health system costs are unlikely to be realized.