Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.
Int J Clin Pract. 2021 May;75(5):e14000. doi: 10.1111/ijcp.14000. Epub 2021 Jan 21.
Lipid control represents a cornerstone in the management of atherosclerotic cardiovascular disease (ASCVD). Nevertheless, little research has explored the factors associated with poor lipid control in patients with dyslipidaemia.
The study aim was to investigate the variables associated with poor lipid control among patients with dyslipidaemia in Jordan.
In addition to socio-demographics, disease and medication-related variables, lipid profile including total cholesterol, LDL-C, HDL-C and triglyceride and other biomedical variables were collected for patients diagnosed with dyslipidaemia using hospital medical charts at three major outpatient clinics in Jordan. The validated 4-item medication adherence scale and the beliefs about medications questionnaire were used to evaluate medication adherence and medication beliefs among the study participants. The participants were classified to have controlled and uncontrolled dyslipidaemia using recent AHA guidelines. A stepwise forward conditional binary regression was conducted to explore the variables significantly and independently associated with dyslipidaemia control. A P-value of < .05 was considered statistically significant.
A total of 228 patients participated in the study. Most of the study participants (61%) were classified to have uncontrolled lipid profile and 60.1% of them were found to have ASCVD. Regression analysis revealed that increased necessity for dyslipidaemia medications increased the odds of dyslipidaemia control (OR = 1.14), whereas active smoking (OR = 0.42), low medication adherence (OR = 0.0.8) and the presence of ASCVD (odd ratio = 0.24) were significantly associated with poor dyslipidaemia control.
Lipid profile has considerable scope for improvement in patients with dyslipidaemia in Jordan. Improving medication adherence by emphasising on medication necessity and simplifying the prescribed dosage regimen, particularly in smoking patients and those who have ASCVD, should be particularly considered in future clinical pharmacy service programmes aim at improving lipid control and health outcomes in patients with dyslipidaemia.
血脂控制是动脉粥样硬化性心血管疾病（ASCVD）管理的基石。然而，很少有研究探讨血脂异常患者血脂控制不佳的相关因素。
本研究旨在探讨约旦血脂异常患者血脂控制不佳的相关变量。
除了社会人口统计学、疾病和药物相关变量外，还通过约旦三家主要门诊诊所的医院病历收集了血脂谱，包括总胆固醇、LDL-C、HDL-C 和甘油三酯以及其他生物医学变量。使用经过验证的 4 项药物依从性量表和药物信念问卷评估了研究参与者的药物依从性和药物信念。根据最近的 AHA 指南，将参与者分为血脂控制良好和控制不佳的两组。采用逐步向前条件二元回归分析探讨与血脂控制显著相关的变量。P 值<0.05 被认为具有统计学意义。
共有 228 名患者参加了研究。大多数研究参与者（61%）被归类为血脂控制不佳，其中 60.1%的患者患有 ASCVD。回归分析显示，增加血脂异常药物的必要性会增加血脂异常控制的几率（OR=1.14），而主动吸烟（OR=0.42）、低药物依从性（OR=0.0.8）和 ASCVD 的存在（比值比=0.24）与血脂异常控制不佳显著相关。
约旦血脂异常患者的血脂谱有很大的改善空间。通过强调药物的必要性和简化规定的剂量方案，特别是在吸烟患者和患有 ASCVD 的患者中，提高药物依从性，应特别考虑在未来的临床药学服务计划中，旨在改善血脂异常患者的血脂控制和健康结果。
