Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust, Leeds LS1 3EX, UK.
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, UK.
Eur J Cardiovasc Nurs. 2022 Jun 30;21(5):430-437. doi: 10.1093/eurjcn/zvab106.
Injectable medicines are increasingly used to manage risk factors for cardiovascular (CV) events, such as dyslipidaemia and diabetes. These include proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. Little is known about perceptions of injectable therapies among CV healthcare professionals (HCPs). This study explores their views to identify relevant facilitators and barriers to the use of injectables with CV benefit.
A 22-question survey was distributed internationally via online channels. In total, 192 anonymous responses were received (43.7% physicians, 32.6% nurses, 16.8% pharmacists, 6.8% others). Among respondents with experience of these medicines, 69.1% had used an injectable PCSK9 inhibitor and 67.0% had used an injectable GLP-1 receptor agonist. Commonly raised issues were resource problems (36.5%), lack of knowledge among colleagues (32.3%), paperwork (32.3%), and lack of patient knowledge (28.1%). Key barriers respondents felt made patients decline these treatments were fear of injection (56.6%), lack of awareness or education (26.4%), and administration issues (15.1%); potential reasons for discontinuation included side effects (46.4%), perceived lack of benefit (28.6%), and local reactions (21.4%). The main topics around injectables requiring further support included managing non-adherent patients (16.2%), troubleshooting with patients (16.2%), and educating colleagues about injectables (12.2%). Preferred educational methods to support HCPs were face-to-face training (43.5%) and online learning (26.1%); favoured formats were based on role playing and case studies.
Healthcare professionals highlighted various potential barriers to initiation, continuation, and adherence with injectable therapies in CV medicine. Although some require healthcare system changes, many could be addressed through simple measures based primarily on enhanced training and support for patients and HCPs.
越来越多的注射用药物被用于控制心血管(CV)事件的风险因素,如血脂异常和糖尿病。这些药物包括前蛋白转化酶枯草溶菌素/柯萨奇蛋白酶 9(PCSK9)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂。对于心血管保健专业人员(HCPs)对注射疗法的看法知之甚少。本研究探讨了他们的观点,以确定使用具有心血管益处的注射剂的相关促进因素和障碍。
通过在线渠道在国际范围内分发了一份包含 22 个问题的调查问卷。共收到 192 份匿名回复(43.7%为医生,32.6%为护士,16.8%为药剂师,6.8%为其他)。在有这些药物使用经验的受访者中,69.1%使用过注射用 PCSK9 抑制剂,67.0%使用过注射用 GLP-1 受体激动剂。常见的问题包括资源问题(36.5%)、同事缺乏知识(32.3%)、文书工作(32.3%)和患者缺乏知识(28.1%)。受访者认为使患者拒绝这些治疗的主要障碍是害怕注射(56.6%)、缺乏意识或教育(26.4%)以及给药问题(15.1%);停药的潜在原因包括副作用(46.4%)、认为没有获益(28.6%)和局部反应(21.4%)。需要进一步支持的注射剂相关主要话题包括管理不依从的患者(16.2%)、与患者解决问题(16.2%)和向同事提供关于注射剂的教育(12.2%)。支持 HCPs 的首选教育方法是面对面培训(43.5%)和在线学习(26.1%);首选的形式是基于角色扮演和案例研究。
医疗保健专业人员强调了心血管医学中启动、持续和坚持使用注射疗法的各种潜在障碍。虽然有些需要医疗保健系统的改变,但许多障碍可以通过主要基于增强患者和 HCPs 的培训和支持的简单措施来解决。