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首页> 外文期刊>Pharmacoepidemiology and drug safety >Variability in abciximab (ReoPro) prescribing: evidence based or budget driven?
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Variability in abciximab (ReoPro) prescribing: evidence based or budget driven?

机译：abciximab（ReoPro）处方的可变性：基于证据还是预算驱动？

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PURPOSE: Abciximab improves outcomes in patients undergoing percutaneous transluminal coronary intervention (PTCA). Clinicians, however, have expressed concerns that they do not have enough budget to administer abciximab to all eligible patients. We studied the patterns of prescribing of abciximab and identified factors that correlate with the level of usage. METHODS: In each of all 13 Dutch PTCA centres one opinion-leading cardiologist was approached to provide data on the abciximab prescribing in their centre and to co-operate in an interview on this topic. We performed linear regression analysis in which the level of abciximab prescribing was the dependent variable. Potential determinants investigated were the number of PTCAs performed, the criteria for abciximab prescribing, funding and possible financial restrictions, participation in clinical trials in the past, percentage stenting, and desired level of abciximab prescribing. RESULTS: All 13 PTCA centres in the Netherlands participated in our study. The level of abciximab prescribing varied from 2 to 36% of all PTCAs. The criteria for patient selection significantly differed between centres. Together budget, investigatorship, size, and type of the institution were highly predictive for the level of abciximab prescribing (R2 = 0.93, p < 0.001). The more patients doctors had included in clinical trials in the past, the higher was the likelihood that they had prescribed abciximab. CONCLUSIONS: Shortly after its introduction, patterns of abciximab prescribing varied widely between PTCA centres. There was no agreement on which patients to select for this preventive treatment. Budget and involvement in clinical trials in the past were important predictors of the level of prescribing in each centre.
机译：目的：阿昔单抗改善接受经皮腔内冠状动脉介入治疗（PTCA）的患者的预后。但是，临床医生对他们没有足够的预算向所有合格患者服用abciximab表示担忧。我们研究了阿昔单抗的处方模式，并确定了与使用水平相关的因素。方法：在所有13个荷兰PTCA中心中的每一个中，都邀请一位意见领先的心脏病专家提供其中心处方abciximab的数据，并就此主题进行访谈。我们进行了线性回归分析，其中阿昔单抗处方的水平是因变量。研究的潜在决定因素包括执行的PTCA数量，阿昔单抗处方的标准，资金和可能的财务限制，过去参与的临床试验，支架的百分比以及阿昔单抗处方的期望水平。结果：荷兰的所有13个PTCA中心都参加了我们的研究。在所有PTCA中，阿昔单抗处方水平从2％到36％不等。中心之间患者选择的标准明显不同。预算，研究人员，机构规模和机构类型一起对abciximab处方水平具有高度预测性（R2 = 0.93，p <0.001）。过去，医生在临床试验中纳入的患者越多，他们开具阿昔单抗的可能性就越高。结论：引入阿昔单抗后不久，PTCA各中心之间的处方方式差异很大。对于选择哪种患者进行这种预防性治疗尚无共识。过去的预算和参与临床试验是每个中心处方水平的重要预测指标。

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