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首页> 外文期刊>Journal of the American Geriatrics Society >Asthma pharmacotherapy prescribing in the ambulatory population of the United States: evidence of nonadherence to national guidelines and implications for elderly people.
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Asthma pharmacotherapy prescribing in the ambulatory population of the United States: evidence of nonadherence to national guidelines and implications for elderly people.

机译：在美国非卧床人群中进行哮喘药物治疗的处方：不遵守国家指导原则和对老年人的影响的证据。

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OBJECTIVES: To examine the level of physician adherence to the Expert Panel Report 2 (EPR-2) pharmacotherapy guidelines of the asthma population, specifically in the elderly ambulatory patient population of the United States. DESIGN: Retrospective cross-sectional study using a national survey. SETTING: National Ambulatory Medical Care Survey data of U.S. elderly patients from 1998 through 2004. PARTICIPANTS: The weighted population sample size was 82,020,318 patients. There were 1,540 observations in this study (preweighted sample size) and 96 strata, with 446 population sampling units (PSUs). There were 11,868,340 patients that were elderly, and they accounted for 14.5% of the overall population sampled. MEASUREMENTS: Specific patient demographic variables, physician demographic variables, and information about asthma medications prescribed were extracted from the data set and analyzed. Descriptive statistics for the patient demographic, physician demographic, and asthma pharmacotherapy variables weregenerated. A series of logistic regression models were created, with the choice of asthma pharmacotherapy agent used as the dependent variable and patient and physician demographic variables as the independent variables. RESULTS: A major finding was that physicians were not adherent to the National Asthma Education and Prevention Program EPR-2 asthma pharmacotherapy guidelines. Another finding was that, although elderly patients (aged >or=65) were exposed to more-stable patterns of care, they were less likely to be prescribed controller medications, long-acting bronchodilators (LABAs), combinations of inhaled corticosteroids and LABAs, and short-acting beta agonists than patients aged 35 to 64. CONCLUSION: A more-concerted effort needs to be undertaken to improve physician adherence to the EPR-2 guidelines, especially in prescribing asthma pharmacotherapy to elderly patients.
机译：目的：检查医师对哮喘人群（特别是美国老年门诊患者人群）的专家小组报告2（EPR-2）药物治疗指南的依从程度。设计：采用国家调查的回顾性横断面研究。地点：1998年至2004年美国老年患者的国家门诊医疗调查数据。参与者：加权人群样本量为82,020,318例。在这项研究中，有1,540个观测值（预先加权的样本量）和96个阶层，有446个人口抽样单位（PSU）。有11,868,340位老年患者，他们占总样本量的14.5％。测量：从数据集中提取特定的患者人口统计学变量，医生人口统计学变量以及有关处方药的信息。生成了患者人口统计，医生人口统计和哮喘药物治疗变量的描述性统计数据。建立了一系列逻辑回归模型，选择哮喘药物治疗药物作为因变量，选择患者和医生的人口统计学变量作为自变量。结果：一个主要发现是医师未遵守美国国家哮喘教育和预防计划EPR-2哮喘药物治疗指南。另一个发现是，尽管老年患者（年龄大于或等于65岁）接受了更稳定的护理，但他们不太可能开处方控制药物，长效支气管扩张剂（LABAs），吸入性糖皮质激素和LABA的组合，以及比35至64岁的患者更短效的β受体激动剂。结论：需要做出更加令人信服的努力，以提高医师对EPR-2指南的依从性，尤其是在对老年患者进行哮喘药物治疗时。

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