• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The journal of clinical hypertension. >Prevalence of True Therapeutic Inertia in Blood Pressure Control in an Academic Chronic Kidney Disease Clinic
【24h】

Prevalence of True Therapeutic Inertia in Blood Pressure Control in an Academic Chronic Kidney Disease Clinic

机译：慢性肾脏病学术诊所血压控制中的真实治疗惯性患病率

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Therapeutic inertia (TI) in blood pressure (BP) control has been traditionally defined as failure to initiate or intensify therapy when treatment goals are not met. The fallacy with this definition is that TI may be overestimated because it includes hypertensive patients deliberately uncontrolled. This is a retrospective chart review study that evaluated physicians' response to an uncontrolled clinic BP reading in a population of patients with stage 3 to 5 chronic kidney disease (CKD) and hypertension. Of 429 patients screened, 166 had controlled BP and 263 did not. Of these 263 patients, 115 patients had no clear reason documented for the absence of changes in medication regimen. This population was defined as cases with true TI. In the remaining 148 patients, the medication regimen was changed in 81 patients. In the rest of the patients, there was a reason documented for not changing the medication regimen. The prevalence of true TI rate (defined as percentage of uncontrolled hypertension as a result of physician inaccountability) in our study was 44% as compared with 69% if the traditional TI definition is applied. Thus, we conclude that the prevalence of TI in the literature overestimates the rate of true TI as it does not account for physician decision making. The current definition of TI in BP control needs to be revised, as it underestimates a provider's care to improve BP control and is misleading. The TI definition should include some mechanism to account for interventions beyond medication titration.
机译：传统上将血压（BP）控制中的治疗惯性（TI）定义为未达到治疗目标时无法启动或加强治疗。这种定义的谬误是TI可能被高估了，因为它包括故意不受控制的高血压患者。这是一项回顾性图表审查研究，评估了3至5期慢性肾脏病（CKD）和高血压患者群体中医生对不受控制的临床BP读数的反应。在筛查的429例患者中，有166例控制了血压，而263例没有控制。在这263名患者中，有115名患者没有明确的理由证明没有改变用药方案。该人群定义为真正的TI患者。在其余的148位患者中，有81位患者改变了用药方案。在其余的患者中，有记录的原因是未改变用药方案。在我们的研究中，真实TI​​发生率（定义为由于医生的不负责任而导致的无法控制的高血压百分比）的患病率为44％，而采用传统TI定义的患病率为69％。因此，我们得出的结论是，文献中TI的流行率高估了真实TI的发生率，因为它不能解释医师的决策。当前对BP控制中TI的定义需要修改，因为它低估了提供者对改善BP控制的关注，并且具有误导性。 TI的定义应包括某种机制，以解释药物滴定以外的干预措施。

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