...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Patient Preference and Adherence >Factors associated with β-blocker initiation and discontinuation in a population-based cohort of seniors newly diagnosed with heart failure
【24h】

Factors associated with β-blocker initiation and discontinuation in a population-based cohort of seniors newly diagnosed with heart failure

机译：在新诊断为心力衰竭的老年人群中，与β受体阻滞剂启动和终止相关的因素

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Purpose: β-Blockers (bisoprolol, carvedilol, and metoprolol) are the cornerstone of heart failure (HF) management. The incidence rate of β-blocker initiation and discontinuation and their associated factors among seniors with a first HF diagnosis were assessed. Methods: A population-based inception cohort study that included all individuals aged ≥65 years with a first HF diagnosis in Quebec was conducted. β-Blockers initiation among 91,131 patients who were not using β-blockers at the time of HF diagnosis and discontinuation among those who initiated a β-blocker after HF diagnosis were assessed. Stepwise Cox regression analyses were used to calculate hazard ratios (HR) and to identify factors associated with β-blocker initiation and discontinuation. Results: After HF diagnosis, 32,989 (36.2%) individuals initiated a β-blocker. Of these, 15,408 (46.7%) discontinued their β-blocker during the follow-up. Individuals more likely to initiate a β-blocker were those diagnosed in a recent calendar year (2009: HR, 2.11; 95% confidence interval [CI], 2.00–2.23) and diagnosed by a cardiologist (HR, 1.38; 95% CI, 1.34–1.42). Individuals less likely to initiate were those aged ≥90?years (HR, 0.65; 95% CI, 0.61–0.68) and those with chronic obstructive pulmonary disease (HR, 0.66; 95% CI, 0.64–0.68). Individuals more likely to discontinue were those with more than nine medical consultations (HR, 1.14; 95% CI, 1.10–1.18) and those with dementia (HR, 1.13; 95% CI, 1.01–1.27). Individuals less likely to discontinue were those diagnosed in a recent calendar year (2009: HR 0.74; 95% CI, 0.65–0.82) and those exposed to another β-blocker before HF diagnosis (HR, 0.88; 95% CI, 0.85–0.91). Conclusion: Quebec seniors seem to be underexposed to β-blocker following HF diagnosis. Among those who initiate β-blocker use, discontinuation is high. Better understanding of the underlying causes is needed to help target interventions to improve the management of HF.
机译：目的：β受体阻滞剂（比索洛尔，卡维地洛和美托洛尔）是治疗心力衰竭（HF）的基石。评估初次HF诊断的老年人中β受体阻滞剂启动和终止的发生率及其相关因素。方法：进行了一项基于人群的初始队列研究，该研究纳入了魁北克首次≥HF诊断的所有≥65岁的个体。评估了91,131例在进行HF诊断时未使用β受体阻滞剂的患者中β受体阻滞剂的起始情况以及在HF诊断后开始使用β受体阻滞剂的患者中止的情况。 Cox逐步回归分析用于计算危险比（HR）并确定与β受体阻滞剂启动和终止有关的因素。结果：HF诊断后，有32,989（36.2％）个人启动了β受体阻滞剂。其中，有15408（46.7％）人在随访期间停用了其β受体阻滞剂。更有可能引发β受体阻滞剂的患者是最近一个日历年（2009年：HR，2.11; 95％置信区间[CI]，2.00–2.23），并由心脏病专家诊断（HR，1.38; 95％CI， 1.34–1.42）。发起可能性较小的人群是≥90岁的人群（HR，0.65; 95％CI，0.61-0.68）和患有慢性阻塞性肺疾病的人群（HR，0.66; 95％CI，0.64-0.68）。停药可能性更大的个体是接受过九次以上医疗咨询的患者（HR，1.14; 95％CI，1.10-1.18）和痴呆症患者（HR，1.13; 95％CI，1.01-1.27）。停药可能性较小的患者是最近一个日历年中诊断出的患者（2009年：HR 0.74; 95％CI，0.65-0.82）和在HF诊断之前接触过另一种β受体阻滞剂的患者（HR，0.88; 95％CI，0.85-0.91） ）。结论：HF诊断后，魁北克老年人似乎未充分暴露于β受体阻滞剂。在开始使用β受体阻滞剂的人群中，停用率很高。需要更好地了解根本原因，以帮助目标干预措施以改善心力衰竭的管理。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号