摘要
目的探讨我国不同基层医疗机构中高血压基本药物的可及性及影响药物使用的相关因素。方法2019年6月4日至8月5日期间,全国共4062名基层医疗机构的医生参与本次调查。依据《2017国家基本医保目录》,将其中与高血压治疗相关的8大类、70种口服降压药物作为本研究的调查药物,以世界卫生组织/国际卫生行动组织(WHO/HAI)标准调查法中的可获得率作为可及性的评价指标,采用德尔菲法制定调查表,通过手机微信链接模式完成数据采集,对乡镇及城市基层医疗机构中的可及性进行对比分析。同时,以可获得后的使用/不使用作为因变量,以工作年限、职称、城市/乡镇、地区作为自变量,进行logistic回归分析。结果(1)全部基层医疗机构中,总体可及性高(可获得率>75%)的药物有:复方利血平氨苯蝶啶(0号)(88.4%)、硝苯地平(76.9%);总体可及性较高(可获得率50%~75%)的药物有:吲达帕胺(65.3%)、美托洛尔(61.6%)、氨氯地平(57.4%)、卡托普利(55.9%)、缬沙坦(53.9%)、复方利血平(复方降压片)(53.2%)、依那普利(52.6%)、氢氯噻嗪(51.3%)、厄贝沙坦(50.5%)。(2)除总体可及性高的复方利血平氨苯蝶啶以外,仅总体可及性一般(可获得率25%~50%)的尼群地平、总体可及性低(可获得率0%~25%)的地巴唑、萘哌地尔、肼屈嗪、米诺地尔在乡镇基层医疗机构中的可及性明显高于城市基层医疗机构。(3)复方利血平氨苯蝶啶、吲达帕胺、美托洛尔、硝苯地平、卡托普利分别为抗高血压药与利尿剂复方制剂、利尿剂、β受体阻滞剂、钙通道阻滞剂、血管紧张素转换酶抑制药/血管紧张受体阻滞药(ACEI/ARB)等5类降压药中总体可获得率最高的药物。Logistic回归分析显示,医生工作年限及职称、所在乡镇/城市基层医疗机构以及所在地区与这些药物可获得后的使用/不使用相关。结论复方利血平氨苯蝶啶、硝苯地平在我国�
Objective To explore the accessibility of anti-hypertensive drugs in different primary medical institutions in China and the related factors affecting drug usage.Methods From June 4 to August 52019,a total of 4062 Chinese clinicians participated in the survey.According to the"2017 national basic medical insurance directory",8 categories and 70 kinds of oral antihypertensive drugs were used as the investigated drugs in this study.Availability rate in WHO/HAI(World Health Organization/Health Action International)standard survey method was used as the evaluation indicator of accessibility.Questionnaire was developed using the Delphi method,and data were collected through mobile WeChat link mode.Furtherly,the accessibilities of anti-hypertensive drugs were compared and analyzed in township and urban primary medical institutions.At the same time,logistic regression analysis was carried out with the use/no-use of available drugs as the dependent variable,and the working years,professional titles,cities/towns and regions as independent variables.Results(1)In all primary medical institutions,the drugs with highest overall accessibility(availability rate>75%)included compound reserpine and amitripterine(88.4%)and nifedipine(76.9%).The drugs with higher overall accessibility(availability rate 50%-75%)included indapamide(65.3%),metoprolol(61.6%),amlodipine(57.4%),captopril(55.9%),valsartan(53.9%),compound reserpine(compound antihypertensive tablets)(53.2%),enalapril(52.6%),hydrochlorothiazide(51.3%)and irbesartan(50.5%).(2)Compound reserpine and amitripterine,nitrendipine,dibazol,naftopidil,hydralazine and minoxidil in township primary medical institutions were statistically higher than that in urban primary medical institutions.(3)In five kinds of antihypertensive and diuretic compound,diuretics,β-blockers,calcium channel blockers and angiotensin converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ARB),the most available durgs was compound reserpine and amitripterine,indapamide,metoprolol,nifedipine and captopri
作者
喜杨
陈源源
郝玉明
钟萍
王胜煌
王浩
卜培莉
李燕
韩清华
余静
孙刚
孙宁玲
王鸿懿
中国医疗保健国际交流促进会高血压分会
基层医疗机构高血压基本药物的可及性调查项目组
XI Yang;CHEN Yuan-yuan;HAO Yu-ming;ZHONG Ping;WANG Sheng huang;WANG Hao;BU Pei-li;LI Yan;HAN Qing-hua;YU Jing;SUN Gang;SUN Ning-ling;WANG Hong-yi;Hyper tension Branch of China Association for the Promotion of International Exchanges of Health Care;the Project Team on the Accessibility Survey of Anti-Hypertensive Drugs in Primary Medical Institutions(Department of Hypertension Laborutury,Heart Center,Peking University People's Hospital,100044,China;Department of Cardiology,Second Hospital of Hebei Medical University;Department of Cardiology,People's Hospital of Sichuan Province;Department of Cardiology,First Hospital of Ningbo City;Department of Hypertension,People's Hospital of Henan Province;Depart merit of Cardiology,Qilu Hospital,Shandong University;Shanghai Institute of Hypertension;Department of Cardiology,First Affiliated Hospital of Shanxi Medical University;Department of Cardiology,Lanzhou University Second Hospital;Department of Cardiology,Second Affiliated Hospital of Buolou Medical College;不详)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2021年第9期825-833,共9页
Chinese Journal of Hypertension
关键词
基层医疗机构
高血压
可及性
可获得率
基本药物
primary medical institution
hypertension
accessibility
availability rate
essential drug
