University of Florence, School of Medicine, Florence, Italy.
Postgrad Med. 2009 Nov;121(6):44-53. doi: 10.3810/pgm.2009.11.2070.
Few surveys have assessed physicians' attitudes toward preventive treatment in post-myocardial infarction (MI) patients, although these patients have a high risk of recurrence. A newly developed online survey, which aimed to determine physicians' attitudes toward aspirin prophylaxis post-MI, was sent to physicians in 18 countries. This report describes findings from 7 European (n = 2842 respondents) and 2 Latin American (n = 149 respondents) countries. Although low-dose aspirin therapy was recommended by most physicians (> 90%), compliance was suboptimal; 29% of patients in Europe and 35% in Latin America were partially or totally noncompliant, and 18% of physicians in Europe and 20% in Latin America had lost contact with their patients. Low-dose aspirin monotherapy or combination therapy, dosage, and physician contact all had a significant effect on compliance (P < 0.00001). Shared decision making by the physician and patient was rated as the most effective measure to improve compliance, which clearly indicates the need for a change in management.
很少有调查评估过医生对心肌梗死后（MI）患者预防治疗的态度，尽管这些患者有很高的复发风险。一项新开发的在线调查旨在确定医生对 MI 后阿司匹林预防的态度，已发送至 18 个国家的医生。本报告描述了来自 7 个欧洲国家（n = 2842 名受访者）和 2 个拉丁美洲国家（n = 149 名受访者）的发现。尽管大多数医生（>90%）推荐低剂量阿司匹林治疗，但依从性并不理想；欧洲 29%的患者和拉丁美洲 35%的患者部分或完全不依从，欧洲 18%的医生和拉丁美洲 20%的医生与患者失去联系。低剂量阿司匹林单药或联合治疗、剂量和医生接触均对依从性有显著影响（P<0.00001）。医生和患者共同决策被评为提高依从性的最有效措施，这清楚地表明需要改变治疗方法。
