TOPICAL B-BLOCKER SIDE EFFECTS IN ELDERLY

局部应用β受体阻滞剂是青光眼的主要治疗方法 治疗 虽然有良好的数据， 局部β受体阻滞剂降低眼内压，非常少 已知全身不良反应的流行病学， 这种常见的治疗方法，特别是在老年人中。 本研究将分析眼科药物的药物流行病学 β-受体阻滞剂副作用在超过100万的人群中 病人在新泽西，通过计算机辅助调查， 新泽西医疗补助计划中所有接受者的数据集 （N= 975，700），以及老年人药房援助 残疾人项目（PAAD）（N= 250，000）。 这些完整的记录 药物使用数据和所有其他报销的医疗保健 服务（包括办公室访问，紧急服务， 住院和长期护理）将跟踪患者- 具体的基础上，并补充了所有医疗保险索赔数据 （A部分和B部分，也是按个人情况而定）。 流行病学分析将采用随访（队列）的形式 研究中，暴露于眼用β受体阻滞剂后， 噻吗洛尔或倍他洛尔。 利息的结果将是 针对充血性心脏等临床事件的医疗保健接触 衰竭、支气管痉挛、抑郁或意识模糊。 这些将是 不仅通过医生访问或医院等措施进行跟踪， 而且还通过追踪药物使用模式 用于治疗这些病症的处方药（例如利尿剂，地高辛， 支气管扩张剂、抗抑郁药等）。 标准流行病学 技术将被用来回答以下问题：（1）是 研究的全身性副作用的风险增加 青光眼患者使用局部β-受体阻滞剂， 这种风险的大小？ (2)是否有重要的辅助因素， 预测某些青光眼亚组的风险升高 患者，如年龄、特定合并症、合并用药 使用等？ (3)在临床上， 倍他洛尔和噻吗洛尔对研究结果的影响？ (4)如果 不良反应风险的差异在使用 这些药物，它对实践的影响是什么？ 青光眼患者的护理

Topically applied beta-blockers are a mainstay of glaucoma treatment. While there exist good data concerning the efficacy of topical beta-blockers in reducing intraocular pressure, very little is known about the epidemiology of systemic adverse effects from this common therapy, particularly in the elderly. This study will analyze the pharmaco-epidemiology of ophthalmic beta-blocker side effects in a population of over 1 million patients in New Jersey, through computer-assisted investigation of a dataset of all recipients in the New Jersey Medicaid program (N=975,700), as well as int the Pharmacy Assistance for the Aged and Disabled program (PAAD) (N=250,000). These complete records of medication use data and all other reimbursed health care services (including office visits, emergency services, hospitalizations, and long-term care) will be tracked on a patient- specific basis and supplemented with all Medicare claims data (Parts A and B, also on a person-specific basis). Epidemiologic analysis will take the form of follow-up (cohort) studies, after exposure to an ophthalmic beta-blocker, either timolol or betaxolol. Outcomes of interest will be the rate of health care encounters for clinical events such as congestive heart failure, bronchospasm, depression, or confusion. These will be tracked not only by measures such as physician visits or hospital stays, but also by tracing the pattern of use of medications prescribed to treat these conditions (e.g. diuretics, digoxin, bronchodilators, antidepressants, etc.). Standard epidemiologic techniques will be used to answer the following questions: (1) Is there an increased risk of the systemic side effects studied in glaucoma patients using topical beta-blockers, and what is the magnitude of such risk? (2) Are there important co-factors that predict elevated risk among certain subgroups of glaucoma patients, such as age, specific comorbidity, co-existing medication use, etc.? (3) Is there a clinically important difference between betaxolol and timolol in regard to the outcomes studied? (4) If differences in adverse effect risk are found in patients using these medications, what are its implications for practice in the care of glaucoma patients?