Quality of Co-Prescribing NSAID and Gastroprotective Medications for Elders in The Netherlands and Its Association with the Electronic Medical Record.
Quality of Co-Prescribing NSAID and Gastroprotective Medications for Elders in The Netherlands and Its Association with the Electronic Medical Record.
复制标题
荷兰长老的共同处方NSAID和胃保护药物的质量及其与电子病历的关联。
DOI：
10.1371/journal.pone.0129515
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Abu-Hanna A
中科院分区：
文献类型：
--
作者：
Opondo D;Visscher S;Eslami S;Verheij RA;Korevaar JC;Abu-Hanna A
评估随着时间的推移，老年人在全科医疗中联合处方非甾体抗炎药和胃保护药物的指南依从性，并调查其与所使用的电子病历 (EMR) 系统品牌的潜在关联。我们纳入了 2005 年至 2010 年间接受 NSAID 治疗的 65 岁及以上患者。处方数据是从参与荷兰 NIVEL 初级保健数据库的全科医生诊所的 EMR 系统中提取的。我们每隔三个月计算一次全科医生的非甾体抗炎药处方与胃保护药物联合处方的比例。探讨了胃保护比例、电子病历 (EMR) 品牌和全科医生执业类型之间的关联。使用随机效应线性回归模型分析电子病历系统之间胃保护比例的时间趋势。我们纳入了 2005 年至 2010 年间来自 77 个全科诊所的 91,521 名使用 NSAID 处方就诊的患者。老年人服用 NSAID 处方并同时开出胃保护药物的总体比例为 43%。胃保护的平均比例从 2005 年第一季度的 27%（CI 25-29%）每 3 个月增加 1.2% 增加到 2010 年底的 55%（CI 52-58%）。EMR 品牌和全科医生诊所类型与胃保护联合处方独立相关。尽管荷兰向接受非甾体抗炎药的老年患者开出胃保护药物的情况有所增加，但在大约一半的指定病例中并未同时开出这些药物。 EMR系统的品牌与胃保护药物处方的差异相关。 EMR 的优化设计和利用是提高处方质量的潜在干预领域。
To assess guideline adherence of co-prescribing NSAID and gastroprotective medications for elders in general practice over time, and investigate its potential association with the electronic medical record (EMR) system brand used. We included patients 65 years and older who received NSAIDs between 2005 and 2010. Prescription data were extracted from EMR systems of GP practices participating in the Dutch NIVEL Primary Care Database. We calculated the proportion of NSAID prescriptions with co-prescription of gastroprotective medication for each GP practice at intervals of three months. Association between proportion of gastroprotection, brand of electronic medical record (EMR), and type of GP practice were explored. Temporal trends in proportion of gastroprotection between electronic medical records systems were analyzed using a random effects linear regression model. We included 91,521 patient visits with NSAID prescriptions from 77 general practices between 2005 and 2010. Overall proportion of NSAID prescriptions to the elderly with co-prescription of gastroprotective medication was 43%. Mean proportion of gastroprotection increased from 27% (CI 25–29%) in the first quarter of 2005 with a rate of 1.2% every 3 months to 55%(CI 52–58%) at the end of 2010. Brand of EMR and type of GP practice were independently associated with co-prescription of gastroprotection. Although prescription of gastroprotective medications to elderly patients who receive NSAIDs increased in The Netherlands, they are not co-prescribed in about half of the indicated cases. Brand of EMR system is associated with differences in prescription of gastroprotective medication. Optimal design and utilization of EMRs is a potential area of intervention to improve quality of prescription.
登录
查看更多内容
影响因子：
1.9
作者：
Lanas, Angel;Plazas, Ma Josep;Munoz-Tuduri, Marta
通讯作者：
Munoz-Tuduri, Marta
影响因子：
4.7
作者：
Tsai, Yun-Fang;Liu, Li-Ling;Chung, Shih-Chi
通讯作者：
Chung, Shih-Chi
影响因子：
9.8
作者：
Abraham, Neena S.;Hartman, Christine;Smalley, Walter
通讯作者：
Smalley, Walter
影响因子：
--
作者：
van der Ploeg, E.;Depla, M. F. I. A.;Mackenbach, J. P.
通讯作者：
Mackenbach, J. P.
影响因子：
3.1
作者：
TALLEY, NJ;EVANS, JM;MELTON, LJ
通讯作者：
MELTON, LJ