综合干预方案对阿托伐他汀依从性的影响：一项随机对照试验。
Impact of an integrated intervention program on atorvastatin adherence: a randomized controlled trial.
机构信息
Prairie Heart Cardiovascular Consultants, Springfield, IL, USA.
出版信息
Int J Gen Med. 2013 Jul 30;6:647-55. doi: 10.2147/IJGM.S47518. Print 2013.
BACKGROUND
This trial evaluated the effectiveness of an integrated intervention program that included a 3-to-5-minute nurse counseling session, copay relief cards, and a monthly newsletter on adherence to atorvastatin treatment.
METHODS AND RESULTS
A prospective, integrated (composed of nurse counseling, adherence tip sheet, copay relief card, opportunity to enroll in 12-week cholesterol management program) randomized interventional study was designed involving patients >21 years of age who were prescribed atorvastatin at a large single-specialty cardiovascular physician practice in Illinois from March 2010 to May 2011. Data from the practice's electronic medical record were matched/merged to IMS Health's longitudinal data. A total of 500 patients were enrolled (125 in the control arm; 375 in the intervention arm). After data linkage, 53 control patients and 155 intervention patients were included in the analysis.
RESULTS
Mean age was 67.8 years (control) and 69.5 years (intervention); 67.9% and 58.7%, respectively, were male. The mean 6-month adherence rate was 0.82 in both arms. The mean proportion of days covered for both the new-user control and intervention groups was the same, averaging 0.70 day (standard deviation [SD], 0.27 day); for continuing users, the proportion of days covered for the control group was 0.83 (SD, 0.24) and for the intervention group was 0.84 (SD, 0.22). For continuing users, the control group had mean persistent days of 151.6 (SD, 50.2) compared with 150.9 days (SD, 50.9) for the intervention group. New users had fewer persistent days (control 111.4 days, SD, 69.6 days; intervention 112.0 days, SD, 58.8 days) compared with continuing users. The Cox proportional hazards model of the risk of discontinuation with index therapy was not significantly different between the intervention and control groups (hazard ratio 0.83, P = 0.55).
CONCLUSION
The integrated intervention program did not significantly improve atorvastatin adherence relative to usual care in the studied patient population.
背景
本试验评估了一项综合干预计划的效果，该计划包括 3-5 分钟的护士咨询、共付减免卡和关于阿托伐他汀治疗依从性的每月通讯。
方法和结果
一项前瞻性的综合研究（由护士咨询、依从性提示单、共付减免卡和参加 12 周胆固醇管理计划的机会组成）设计涉及伊利诺伊州一家大型专科心血管医生诊所的 21 岁以上开阿托伐他汀处方的患者。从 2010 年 3 月至 2011 年 5 月，该诊所的电子病历数据与 IMS Health 的纵向数据进行了匹配/合并。共纳入 500 例患者（对照组 125 例，干预组 375 例）。数据链接后，纳入分析的对照组患者 53 例，干预组患者 155 例。
结果
平均年龄为对照组 67.8 岁和干预组 69.5 岁；分别为 67.9%和 58.7%为男性。两组的平均 6 个月依从率均为 0.82。新使用者对照组和干预组的平均覆盖天数相同，平均为 0.70 天（标准差 0.27 天）；对于持续使用者，对照组的覆盖天数为 0.83（标准差 0.24），干预组为 0.84（标准差 0.22）。对于持续使用者，对照组的持续天数为 151.6 天（标准差 50.2 天），而干预组为 150.9 天（标准差 50.9 天）。新使用者的持续天数较少（对照组 111.4 天，标准差 69.6 天；干预组 112.0 天，标准差 58.8 天）与持续使用者相比。指数治疗中断风险的 Cox 比例风险模型在干预组和对照组之间无显著差异（风险比 0.83，P = 0.55）。
结论
在研究人群中，综合干预计划并没有显著改善阿托伐他汀的依从性，而不是常规护理。
Zotero 插件