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他汀类药物用于心血管疾病预防:美国 HIV 感染者的认知。

Statin use for cardiovascular disease prevention: perceptions among people living with HIV in the United States.

机构信息

RAND Corporation, Arlington, VA, United States of America.

RAND Corporation, Pittsburgh, PA, United States of America.

出版信息

BMC Prim Care. 2024 Apr 17;25(1):116. doi: 10.1186/s12875-024-02370-z.

Abstract

BACKGROUND

People living with HIV (PLWH) may be at heightened risk for cardiovascular disease (CVD). Statin use and lifestyle changes reduce the risk of CVD but remain under-prescribed among PLWH. The objective of this study was to characterize knowledge of CVD and statin use, current usage, barriers to taking statins, and information desired by PLWH to improve statin uptake among PLWH in Los Angeles, CA.

METHODS

Between April 2019 and April 2020, we conducted four focus group discussions (n = 37) with patients across three public community health clinics that serve PLWH in Los Angeles County, California. All clinics participated in a larger study to improve statin prescribing for PLWH. We asked about knowledge of statins, willingness to take a statin, possible barriers to statin usage, preferred information sources for health information, and desired information about statins. We utilized standard qualitative content analysis methods to identify themes.

RESULTS

We found a range in the awareness of statins, with some participants reporting never having heard of statins while others had a history of statin use. There were concerns about the potential long-term effect of statin use, but participants expressed willingness to use CVD medications generally and statins specifically, especially if recommended by their healthcare provider. Participants also expressed interest in potential alternatives to statin usage such as exercising regularly and nutritious eating.

CONCLUSIONS

More interventions are needed to increase statin use among PLWH to improve CVD outcomes, which also has implications for HIV progression. Clinics should aim to increase patient and provider knowledge about CVD risk and statin use for PLWH and provide shared decision-making tools that are easy to use and culturally appropriate.

摘要

背景

HIV 感染者(PLWH)可能面临更高的心血管疾病(CVD)风险。他汀类药物的使用和生活方式的改变可以降低 CVD 的风险,但在 PLWH 中的使用仍然不足。本研究的目的是描述 PLWH 对 CVD 和他汀类药物使用的认识、当前使用情况、服用他汀类药物的障碍以及 PLWH 希望获得的信息,以提高 PLWH 服用他汀类药物的比例。

方法

2019 年 4 月至 2020 年 4 月,我们在加利福尼亚州洛杉矶县的三家公共社区卫生诊所进行了四次焦点小组讨论(n=37),参与者来自不同的患者群体。所有诊所都参与了一项旨在改善 PLWH 他汀类药物处方的更大规模研究。我们询问了参与者对他汀类药物的了解、服用他汀类药物的意愿、服用他汀类药物的可能障碍、首选的健康信息来源以及对他汀类药物的期望信息。我们采用标准的定性内容分析方法来识别主题。

结果

我们发现参与者对他汀类药物的认识程度存在差异,有些参与者表示从未听说过他汀类药物,而有些参与者则有服用他汀类药物的历史。他们对他汀类药物的潜在长期影响表示担忧,但表示愿意使用 CVD 药物,一般来说,如果得到他们的医疗保健提供者的建议,他们也愿意使用他汀类药物。参与者还对他汀类药物替代疗法表示了兴趣,例如定期锻炼和健康饮食。

结论

需要更多的干预措施来提高 PLWH 服用他汀类药物的比例,以改善 CVD 结局,这也对 HIV 进展有影响。诊所应致力于提高患者和提供者对 PLWH 的 CVD 风险和他汀类药物使用的认识,并提供易于使用且文化适宜的共同决策工具。

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Perceptions of Patients with Primary Nonadherence to Statin Medications.他汀类药物原发性不依从患者的认知。
J Am Board Fam Med. 2021 Jan-Feb;34(1):123-131. doi: 10.3122/jabfm.2021.01.200262.

本文引用的文献

1
Pitavastatin to Prevent Cardiovascular Disease in HIV Infection.匹伐他汀预防 HIV 感染患者的心血管疾病。
N Engl J Med. 2023 Aug 24;389(8):687-699. doi: 10.1056/NEJMoa2304146. Epub 2023 Jul 23.

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