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Secondary Pharmacotherapeutic Prevention among German Primary Care Patients with Peripheral Arterial Disease

机译:德国初级保健患者外周动脉疾病的二级药物治疗预防

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Background. The aim of the study was to determine the secondary preventive medical supply of patients with peripheral arterial disease (PAD) in German primary care.Methods and Results. A population-based case control study was conducted using electronic medical records of patients extracted from the CONTENT primary care database of Heidelberg, Germany, between April 2007 and March 2010. The prescription rates of cardiovascular medication among symptomatic PAD patients were analysed by means of the ATC classification and compared with those of patients with cardiovascular disease (CVD). 479 cases with PAD and 958 sex- and age-matched control CVD patients were identified. PAD patients showed significantly lower prescription rates for cardiac agents (21.7% versus 37%),β-blockers (50.1% versus. 66.2%), and lipid-lowering agents (50.3% versus 55.9%) compared to CVD patients. In contrast, significantly more prescriptions of antidiabetic agents (28.2% versus 20.3%), particularly insulin and analogues (12.5% versus 8%), and calcium channel blockers (29.2% versus 24.3%) were found in PAD patients. Low-dose aspirin use among both PAD and CVD patients was underestimated, as it is available without a prescription.Conclusions. Optimal pharmacotherapeutical care of patients with PAD requires more intensive cardioprotective medication in primary care settings.
机译:背景。该研究的目的是确定德国初级保健机构中外周动脉疾病(PAD)患者的二级预防医疗供应。方法与结果。在2007年4月至2010年3月之间,使用从德国海德堡的CONTENT初级保健数据库中提取的患者电子病历,进行了基于人群的病例对照研究。对有症状的PAD患者的心血管药物处方率进行了分析。将ATC分类并与心血管疾病(CVD)患者进行比较。确定了479例PAD患者和958例性别和年龄匹配的对照CVD患者。与CVD患者相比,PAD患者显示出心脏药物(21.7%对37%),β受体阻滞剂(50.1%对66.2%)和降脂药的处方率显着降低(50.3%对55.9%)。相反,在PAD患者中发现了更多的抗糖尿病药处方(28.2%对20.3%),尤其是胰岛素和类似物(12.5%对8%)和钙通道阻滞剂(29.2%对24.3%)。在PAD和CVD患者中低剂量使用阿司匹林被低估了,因为无需处方即可使用。 PAD患者的最佳药物治疗需要在初级保健机构中使用更深入的心脏保护药物。

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