TOPICAL B-BLOCKER SIDE EFFECTS IN ELDERLY

外用β-受体阻滞剂是青光眼的主要治疗药物 治疗。虽然有很好的数据表明 外用β-受体阻滞剂在降低眼压方面的作用很小 已知全身性不良反应的流行病学 这种常见的疗法，尤其是在老年人中。 本研究将对眼科感染的药物流行病学进行分析。 100多万人口中的β-受体阻滞剂副作用 新泽西州的患者，通过计算机辅助调查 新泽西州医疗补助计划中所有受助人的数据集 (n=975,700)，以及老年药房援助 和禁用程序(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)将对患者进行跟踪- 具体的基础，并辅以所有联邦医疗保险索赔数据 (A及B部，亦按个别人士而定)。 流行病学分析将采取随访(队列)的形式 研究表明，在接触眼用β-受体阻滞剂后， 噻吗洛尔或倍他洛尔。利息的结果将是 遇到充血性心脏等临床事件的医疗保健 失败、支气管痉挛、抑郁或精神错乱。这些将是 不仅通过医生就诊或医院等衡量标准来跟踪 留下来，但也通过追踪药物的使用模式 用于治疗这些疾病的处方(如利尿剂、地高辛、 支气管扩张剂、抗抑郁药等)。标准流行病学 将使用技术来回答以下问题：(1)是 中研究的系统性副作用的风险增加 使用外用β-受体阻滞剂的青光眼患者， 这种风险的大小？(2)有没有重要的辅助因素 预测青光眼某些亚组的风险增加 患者年龄、具体合并症、并存用药情况等 使用等？(3)在临床上是否有重要的区别 倍他洛尔和噻吗洛尔对研究结果的影响？(4)如果 在使用药物的患者中发现副作用风险的差异 这些药物，它对临床实践有什么影响 护理青光眼患者？

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?