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患者自述未使用一级预防他汀类药物治疗的原因。

Patient-Reported Reasons for Not Using Primary Prevention Statin Therapy.

作者信息

DeWitt Cassandra M, Ponce Robert B, Bry Hayley, Wali Soma, Sedlander Erica, Ladapo Joseph A

机构信息

Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.

College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.

出版信息

J Clin Med. 2020 Oct 18;9(10):3337. doi: 10.3390/jcm9103337.

Abstract

Almost half of patients who meet American College of Cardiology/American Heart Association (ACC/AHA) criteria for statin therapy are untreated. We aimed to evaluate patient-reported reasons for not using guideline-recommended statin therapy in a public healthcare system. Achieving this goal is key to addressing gaps in care and reducing preventable cardiovascular morbidity. We surveyed patients who met 2013 ACC/AHA guidelines for statin therapy but were not using statins. The survey probed domains of patient knowledge regarding cardiovascular health and benefits of statins, barriers to use, physician trust, and interest in cardiovascular care. Among 71 patients eligible for guideline-recommended statin therapy but not currently taking statins, 49 (69%) had a high school education or lower, 41 (58%) reported that they were unaware they should be prescribed a statin and 49 (69%) were unaware of the benefits of statins. Almost all patients, 70 (99%), reported caring about their cardiovascular health, 61 (86%) reported that they had a high level of trust in their physician, and 51 (72%) reported a willingness to follow their physician's advice. Despite interest in cardiovascular health, awareness of benefits of statin therapy was low and knowledge of recommended statin therapy was low. Increasing patients' awareness of their eligibility through systematic testing and linkage to statin therapy, along with education, may increase statin use among patients recommended for therapy.

摘要

几乎一半符合美国心脏病学会/美国心脏协会(ACC/AHA)他汀类药物治疗标准的患者未接受治疗。我们旨在评估在公共医疗系统中患者报告的未使用指南推荐的他汀类药物治疗的原因。实现这一目标是解决护理差距和降低可预防心血管疾病发病率的关键。我们对符合2013年ACC/AHA他汀类药物治疗指南但未使用他汀类药物的患者进行了调查。该调查探讨了患者在心血管健康和他汀类药物益处方面的知识领域、使用障碍、对医生的信任以及对心血管护理的兴趣。在71名符合指南推荐的他汀类药物治疗条件但目前未服用他汀类药物的患者中,49名(69%)接受过高中或以下教育,41名(58%)报告称他们不知道自己应该服用他汀类药物,49名(69%)不知道他汀类药物的益处。几乎所有患者,70名(99%),报告关心自己的心血管健康,61名(86%)报告对自己的医生高度信任,51名(72%)报告愿意听从医生的建议。尽管对心血管健康感兴趣,但他汀类药物治疗益处的知晓率较低,推荐的他汀类药物治疗知识也较少。通过系统检测和与他汀类药物治疗的联系以及教育来提高患者对自身适用情况的认识,可能会增加推荐治疗患者中他汀类药物的使用。

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