Baig Sarah, Mughal Shahrauz, Murad Yousuf, Virdee Mandeep, Jalal Zahraa
School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Birmingham B15 2TT, UK.
Worcestershire Acute Hospital Trust Woodrow Drive, Redditch B98 7UB, UK.
Pharmacy (Basel). 2024 Jul 3;12(4):104. doi: 10.3390/pharmacy12040104.
Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers', including doctors, pharmacists, and nurses, on current lipid management for cardiovascular diseases and prescriptions of novel lipid-lowering therapies, and (ii) to explore the challenges and facilitating factors of prescribing novel lipid-lowering therapies through qualitative interviews. Qualitative semi-structured interviews with twelve medical and non-medical prescribers were conducted, around 20-30 min in length. The interviews were audio-recorded and transcribed on an online platform. A thematic analysis was deployed. Four major themes emerged from the analysis: (1) prescribing barriers; (2) prescribing enablers; (3) inter-profession variability; and (4) health literacy. These themes highlighted the contrast between the need for optimal shared decision making and the various constraints in practice. Participants expressed their inexperience with novel lipid-lowering therapies and acknowledged the requirement and importance of these agents for primary cardiovascular disease prevention. Participants recognised confidence and competence as key drivers for prescribing therapies and welcomed further education and training to enhance their skillset. Patients' misconceptions towards current lipid-lowering therapies contributed to their refusal of newer agents, highlighting a requirement to improve patient education. Targeting communities through awareness campaigns was identified as a viable solution.
降低低密度脂蛋白胆固醇水平可降低动脉粥样硬化性心血管疾病的风险。鉴于各种国家和国际指南中纳入的现有及未来新兴降脂疗法组合,本研究的目的是:(i)调查英国开处方者(包括医生、药剂师和护士)对当前心血管疾病血脂管理及新型降脂疗法处方的看法;(ii)通过定性访谈探讨开具新型降脂疗法处方的挑战和促进因素。对12名医学和非医学开处方者进行了时长约20 - 30分钟的定性半结构化访谈。访谈进行了录音,并在一个在线平台上进行了转录。采用了主题分析法。分析得出四个主要主题:(1)处方障碍;(2)处方促成因素;(3)职业间差异;(4)健康素养。这些主题凸显了最佳共同决策需求与实践中各种限制之间的反差。参与者表示他们对新型降脂疗法缺乏经验,并承认这些药物对原发性心血管疾病预防的必要性和重要性。参与者认识到信心和能力是处方治疗的关键驱动因素,并欢迎进一步的教育和培训以提升他们的技能。患者对当前降脂疗法的误解导致他们拒绝使用更新的药物,这凸显了改善患者教育的必要性。通过提高认识运动针对社区被确定为一个可行的解决方案。