National Lipid Association Health Quality and Research Committee, Jacksonville, FL, USA; Emory University, Atlanta, GA, USA.
National Lipid Association Health Quality and Research Committee, Jacksonville, FL, USA; Grady Memorial Hospital, Atlanta, GA, USA.
J Clin Lipidol. 2019 May-Jun;13(3):415-424. doi: 10.1016/j.jacl.2019.04.011. Epub 2019 May 18.
It is important to understand patients' experiences of statin-associated adverse effects to potentially identify those at risk for stopping treatment.
The goal of the STatin Adverse Treatment Experience survey was to describe patients' experiences after reporting ≥1 recent statin-associated adverse event and identify opportunities to improve adherence and outcomes.
The survey was developed in 3 stages: qualitative item development, pilot evaluation of initial item performance, and quantitative evaluation using a large commercial sample. Respondents with self-reported high cholesterol who had taken a statin in the past 2 years and experienced ≥1 statin-associated symptom in the past 6 months were included (N = 1500).
Mean age was 58 years, 40.3% were men, and 43.2% had tried ≥2 statins. Many had clinical comorbidities associated with increased risk for cardiovascular disease (atherosclerotic cardiovascular disease, 22.5%; diabetes, 25.8%; hypertension, 56.0%). The most important patient-reported reasons for continuing current statin therapy (n = 1168; 77.9%) were avoiding a heart attack or stroke, lowering cholesterol, and doctor recommendation. Being bothered by and not being able to tolerate side effects were the main reasons respondents discontinued statins (n = 332; 22.1%). Respondents who discontinued statins reported significantly higher mean Symptom Severity (10.6 vs 8.7, P < .001) and Impact Severity scores (11.8 vs 9.8, P < .001) compared with those who continued.
The STatin Adverse Treatment Experience survey highlights the importance of patients' adverse experiences with statins and how symptom and impact scores affect decisions to continue or discontinue therapy. These data provide a foundation to increase providers' awareness of statin tolerability from the patient's perspective and encourage benefit-risk discussions.
了解患者他汀类药物不良反应的体验对于识别那些有停药风险的患者非常重要。
他汀类药物不良反应治疗体验调查的目的是描述报告最近他汀类药物不良反应≥1 次的患者的体验，并确定改善依从性和结局的机会。
该调查分 3 个阶段进行：定性项目开发、初始项目表现的试点评估以及使用大型商业样本进行定量评估。纳入标准为：自我报告胆固醇高、过去 2 年内服用过他汀类药物且过去 6 个月内经历过≥1 次他汀类药物相关症状的患者（N=1500）。
平均年龄为 58 岁，40.3%为男性，43.2%尝试过≥2 种他汀类药物。许多患者存在增加心血管疾病风险的临床合并症（动脉粥样硬化性心血管疾病，22.5%；糖尿病，25.8%；高血压，56.0%）。继续当前他汀类药物治疗的最重要的患者报告原因（n=1168；77.9%）是避免心脏病发作或中风、降低胆固醇和医生建议。受访者停药的主要原因是出现不良反应且无法耐受（n=332；22.1%）。与继续用药的患者相比，停药的患者报告的症状严重程度（10.6 分比 8.7 分，P<.001）和影响严重程度评分（11.8 分比 9.8 分，P<.001）更高。
他汀类药物不良反应治疗体验调查强调了患者对他汀类药物不良反应的体验的重要性，以及症状和影响评分如何影响继续或停止治疗的决策。这些数据为提高提供者从患者角度了解他汀类药物耐受性的意识提供了基础，并鼓励进行获益-风险讨论。
