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首页> 外文期刊>International journal of clinical pharmacology and therapeutics >Disparity of physician specialties in the management of chronic heart failure: Trend analysis in Taiwan, 2000 - 2010
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Disparity of physician specialties in the management of chronic heart failure: Trend analysis in Taiwan, 2000 - 2010

机译：慢性心力衰竭管理中医生专长的差异：台湾地区的趋势分析，2000年-2010年

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Objective: Chronic heart failure (CHF) is a condition that is daily confronted by clinicians in a variety of medical specialties, where physicians routinely seek optimum pharmacotherapy for their outpatients with CHF. We conducted a population- based study on pharmacotherapy for outpatients with CHF in Taiwan from 2000 to 2010, which focused on drug prescription patterns of different physician specialties. Materials and methods: We retrieved records from the National Health Insurance Research Database of patient ambulatory visits with diagnosed chronic heart failure, when cardiovascular drugs were prescribed. For purposes of this study, anti-chronic heart failure drugs were separated into categories: mortalityreducing agents (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, spironolactone, hydralazine plus nitrates) and symptom-relieving agents (digoxin, diuretics). Thereafter, the trends of prescription patterns related to different physician specialties were analyzed. Results: From 2000 to 2010, the prescription rate of any mortality-reducing agent for CHF outpatients rose from 61.5% to 76.3% while the concomitant rate for digoxin decreased from 47.3% to 45.4%. Compared to internists and family physicians, cardiologists not only prescribed far more mortality-reducing agents from 2000 to 2010 (53.9 - 72.7%, 54.1 - 64.3%, 74.7 - 84.4%, respectively), but also prescribed two or three mortality-reducing drugs. Conclusion: There was a significant improvement of optimal pharmacotherapy for chronic heart failure in Taiwan. We observed that cardiologists were more aggressive than non-cardiologists when deciding whether to prescribe mortality-reducing drugs for heart failure management. However, those factors which influence the prescription patterns of internists and family physicians for their patients with CHF still require additional research.
机译：目的：慢性心力衰竭（CHF）是各种医学专业中临床医生每天都会面对的疾病，在这种情况下，医师通常为其CHF门诊患者寻求最佳的药物治疗。我们于2000年至2010年对台湾的CHF门诊病人进行了基于人群的药物治疗研究，研究的重点是不同专业医生的药物处方模式。资料和方法：我们从国家健康保险研究数据库中检索了在处方了心血管药物的情况下被诊断患有慢性心力衰竭的门诊就诊记录。为了本研究的目的，将抗慢性心力衰竭药物分为以下几类：降低死亡率的药物（血管紧张素转换酶抑制剂，血管紧张素受体阻滞剂，β受体阻滞剂，螺内酯，肼苯哒嗪和硝酸盐）和缓解症状的药物（地高辛，利尿剂） 。此后，分析了与不同医师专业相关的处方模式的趋势。结果：从2000年到2010年，CHF门诊患者降低死亡率的处方率从61.5％上升到76.3％，而地高辛的伴随率从47.3％下降到45.4％。与内科医生和家庭医生相比，心脏病医生不仅在2000年至2010年间开出了更多的降低死亡率的药物（分别为53.9-72.7％，54.1-64.3％，74.7-84.4％），还开出了两种或三种降低死亡率的药物。结论：台湾地区治疗慢性心力衰竭的最佳药物治疗有显着改善。我们观察到，在决定是否开具降低死亡率的药物以治疗心力衰竭时，心脏病专家比非心脏病专家更具攻击性。但是，那些影响内科医师和家庭医生对CHF患者的处方方式的因素仍需要进一步的研究。

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