Ingersgaard Marianne Vie, Helms Andersen Tue, Norgaard Ole, Grabowski Dan, Olesen Kasper
Health Promotion, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Education Department, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Patient Prefer Adherence. 2020 Apr 2;14:675-691. doi: 10.2147/PPA.S245365. eCollection 2020.
Lipid-lowering medications are often prescribed to decrease the risk of micro- and macro-cardiovascular complications related to dyslipidaemia. Despite widespread prescription of lipid-lowering drugs, including statins, adherence to therapy is a challenge worldwide. This systematic review of reviews aimed to conduct a critical appraisal and synthesis of review findings and to provide an overview of the factors that were found to affect adherence to lipid-lowering drugs, focusing on statins, in the reviews.
A systematic review methodology was used. MEDLINE, Embase, and Epistemonikos databases were searched for relevant publications. AMSTAR 2 criteria were used to assess the quality of the selected publications.
From a total of 763 screened publications, 9 met all inclusion criteria and were included in this synthesis. Several factors were identified as being associated with adherence to lipid-lowering agents. Among them, high socio-economic and educational position, and middle age had a positive effect on adherence to lipid-lowering agents. Contrary, female sex, older and younger age, non-white race, low socio-economic position, high co-payments, being a new statin user, comorbidities, side effects, regimen complexity, type and intensity of statin dose, smoking, alcohol consumption, imperceptible benefits, and medical distrust contributed to non-adherence. The overall quality of the included reviews was considered critically low to moderate.
This review of reviews has evaluated the impact of factors on adherence statins. Further research related to modifiable predictors for non-adherence is warranted.
降脂药物常用于降低与血脂异常相关的微血管和大血管并发症风险。尽管包括他汀类药物在内的降脂药物广泛应用，但在全球范围内，治疗依从性仍是一项挑战。本系统综述旨在对综述结果进行批判性评价和综合分析，并概述在这些综述中发现的影响降脂药物（重点是他汀类药物）依从性的因素。
采用系统综述方法。检索MEDLINE、Embase和Epistemonikos数据库中的相关出版物。使用AMSTAR 2标准评估所选出版物的质量。
在总共763篇筛选出的出版物中，9篇符合所有纳入标准并被纳入本综述。确定了几个与降脂药物依从性相关的因素。其中，高社会经济和教育地位以及中年对降脂药物依从性有积极影响。相反，女性、老年和年轻、非白人种族、低社会经济地位、高额自付费用、新使用他汀类药物、合并症、副作用、治疗方案复杂性、他汀类药物剂量类型和强度、吸烟、饮酒、难以察觉的益处以及对医疗的不信任导致不依从。所纳入综述的总体质量被认为极低至中等。
本综述评估了各因素对他汀类药物依从性的影响。有必要针对不依从的可改变预测因素开展进一步研究。
