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血脂管理患者与提供者评估(PALM)登记研究的设计与原理

Design and rationale for the Patient and Provider Assessment of Lipid Management (PALM) registry.

作者信息

Navar Ann Marie, Wang Tracy Y, Goldberg Anne C, Robinson Jennifer G, Roger Veronique L, Wilson Peter F, Virani Salim S, Elassal Joesph, Lee L Veronica, Webb Laura E, Peterson Eric

机构信息

Duke Clinical Research Institute, Durham, NC.

Duke Clinical Research Institute, Durham, NC.

出版信息

Am Heart J. 2015 Nov;170(5):865-71. doi: 10.1016/j.ahj.2015.08.002. Epub 2015 Aug 7.

Abstract

BACKGROUND

Despite improvements in diagnosis and treatment, the prevalence of hyperlipidemia among adults in the United States remains high. Data are limited on treatment patterns and patient perceptions of cardiovascular disease risk since the release of new lipid guidelines.

OBJECTIVES

The objectives of the PALM registry are to assess contemporary patterns of lipid-lowering therapy use among adults receiving care in a nationally representative cohort of community clinics, determine consistency of treatment with varying lipid guidelines, identify factors affecting use of lipid-lowering therapy including patient-reported statin intolerance, and assess patient and provider knowledge of cardiovascular risk reduction goals.

STUDY DESIGN

The PALM registry will enroll 7,500 patients likely to be considered for lipid-lowering therapy from 175 cardiology, primary care, and endocrinology practices across the United States. In this cross-sectional, observational registry, a novel tablet-based platform will be used to collect patient-reported knowledge, attitudes, and beliefs regarding cardiovascular risk reduction and lipid management. Chart abstraction and core laboratory lipid levels will describe current lipid management. Provider surveys will assess perception of current lipid-lowering goals and barriers to optimal cardiovascular risk reduction.

CONCLUSION

The PALM registry will allow for better understanding of current practice patterns, patient experiences, and patient and provider attitudes toward cholesterol management for cardiovascular disease risk reduction. These data can be used to better understand gaps in care and design targeted interventions to improve uptake of lipid-lowering therapies for cardiovascular risk reduction.

摘要

背景

尽管在诊断和治疗方面有所改善,但美国成年人高脂血症的患病率仍然很高。自新的血脂指南发布以来,关于治疗模式和患者对心血管疾病风险的认知的数据有限。

目的

PALM注册研究的目的是评估在全国具有代表性的社区诊所队列中接受治疗的成年人使用降脂治疗的当代模式,确定不同血脂指南下治疗的一致性,识别影响降脂治疗使用的因素,包括患者报告的他汀类药物不耐受情况,并评估患者和医疗服务提供者对心血管风险降低目标的了解。

研究设计

PALM注册研究将从美国各地175家心脏病学、初级保健和内分泌科诊所招募7500名可能被考虑进行降脂治疗的患者。在这个横断面观察性注册研究中,将使用一个基于平板电脑的新型平台来收集患者报告的关于心血管风险降低和血脂管理的知识、态度和信念。病历摘要和核心实验室血脂水平将描述当前的血脂管理情况。对医疗服务提供者的调查将评估对当前降脂目标的认知以及实现最佳心血管风险降低的障碍。

结论

PALM注册研究将有助于更好地了解当前的实践模式、患者体验以及患者和医疗服务提供者对降低心血管疾病风险的胆固醇管理的态度。这些数据可用于更好地理解护理中的差距,并设计有针对性的干预措施,以提高降脂治疗对降低心血管风险的接受度。

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