Managing chronic obstructive pulmonary disease in primary care: clinical characteristics of patients receiving inhaled corticosteroids

IF 1 Q4 PHARMACOLOGY & PHARMACY Journal of Pharmacy Practice and Research Pub Date : 2022-10-04 DOI:10.1002/jppr.1835
Madisyn Strain PharmD, BCPS, BCACP, Kaci Boehmer PharmD, BCACP, CDCES, Justin Usery PharmD, BCPS
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Abstract

Inhaled corticosteroid (ICS) therapy in patients with chronic obstructive pulmonary disease (COPD) has been associated with a variety of unfavourable effects, including increased risk of pneumonia, and is only recommended if specific characteristics are present to ensure patients derive the most benefit.
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初级保健中慢性阻塞性肺疾病的管理:接受吸入皮质类固醇患者的临床特征
慢性阻塞性肺疾病(COPD)患者吸入皮质类固醇(ICS)治疗与多种不良反应相关,包括肺炎风险增加,仅在存在特定特征以确保患者获得最大益处的情况下才推荐使用。目的:本研究的主要目的是评估在一个学术医疗中心的两个初级保健诊所使用ICS治疗COPD的患者的临床特征。次要目的是检查提供者的评估和障碍,以处方模式符合门诊护理设置的指导方针。方法在美国阿肯色州的一个学术医疗中心的两个初级保健诊所进行了为期24个月的回顾性研究,重点研究了给予ICS维持治疗的成年患者。根据2019年1月1日至2020年12月31日指示COPD的疾病分类第十版临床修改(ICD-10-CM)代码对每个诊所内的个体进行鉴定。还需要肺量测定来确认诊断。结果在确定的189例独特患者中,有100例符合临床特征审查的条件。所有患者均接受ICS联合长效β受体激动剂(LABA)治疗,55%的患者同时接受长效毒蕈碱拮抗剂(LAMA)治疗。此外,32%的患者在过去一年内因慢性阻塞性肺病加重而就诊或住院。大约47%和36%的患者分别有肺炎史和嗜酸性粒细胞计数100个细胞/mcL。通过与每个诊所的提供者进行公开讨论,确定了遵循指南的障碍,其中包括诊所环境中缺乏现成的资源,电子病历中临床工具的次优识别以及可选择的指南偏好。研究中评估的一小部分患者被发现具有提示强大ICS益处的临床特征,因为这些治疗要么由于低血嗜酸性粒细胞计数或加重率(分别为80%和68%)而缺乏疗效,要么增加了该人群继发于先前肺炎诊断的危害风险(47%)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Pharmacy Practice and Research
Journal of Pharmacy Practice and Research Health Professions-Pharmacy
CiteScore
1.60
自引率
9.50%
发文量
68
期刊介绍: The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.
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