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动脉粥样硬化性心血管疾病的持续肆虐:多学科和创新的以患者为中心方法的重要性。

The Continuing Scourge of Atherosclerotic Cardiovascular Disease: Importance of Multidisciplinary and Innovative Person-Centred Approaches.

机构信息

Trillium Health Partners and Unity Health Toronto and Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

出版信息

Can J Cardiol. 2024 Aug;40(8S):S43-S52. doi: 10.1016/j.cjca.2024.06.001.

Abstract

This article discusses the complex approach to managing atherosclerotic cardiovascular disease (ASCVD), focusing on person-centred care (PCC) to align treatment strategies with individual patient narratives, values, and preferences. It identifies significant challenges in management of ASCVD, such as the necessity for multidisciplinary strategies and the need for enhanced patient care, particularly given the coexistence of ASCVD with other cardiometabolic risk factors. The paper points out existing practice gaps, including limited patient-provider information sharing and decision making, and considers the role of technology in personalizing care and improving outcomes. Strategies such as electronic health records, telehealth platforms, and motivational interviewing are examined for their potential to boost patient engagement and adherence to treatment. In addition, the article discusses systemic issues such as health care provider burnout and the importance of creating customized care plans for patients with multiple health conditions. The integration of varied approaches, including the involvement of community pharmacists and health coaches, is suggested as important for effective management of ASCVD. This review highlights the need for an innovative, holistic strategy for management of ASCVD and advocates for a transformative shift toward PCC that integrates individual, community, and system-level interventions to enhance patient engagement, therapy adherence, and overall outcomes.

摘要

本文探讨了管理动脉粥样硬化性心血管疾病(ASCVD)的复杂方法,重点关注以患者为中心的护理(PCC),使治疗策略与个体患者的叙述、价值观和偏好保持一致。文中确定了 ASCVD 管理中的重大挑战,例如需要多学科策略和加强患者护理的必要性,特别是考虑到 ASCVD 与其他心血管代谢危险因素共存的情况。本文指出了现有实践中的差距,包括患者与提供者之间信息共享和决策制定的有限性,并考虑了技术在个性化护理和改善结果方面的作用。探讨了电子健康记录、远程医疗平台和动机性访谈等策略,以评估它们提高患者参与度和治疗依从性的潜力。此外,文章还讨论了医疗保健提供者倦怠等系统性问题,以及为患有多种健康状况的患者制定定制护理计划的重要性。本文建议整合各种方法,包括社区药剂师和健康教练的参与,对于 ASCVD 的有效管理非常重要。这篇综述强调了需要一种创新的、整体的 ASCVD 管理策略,并提倡向以患者为中心的护理转型,将个体、社区和系统层面的干预措施结合起来,以提高患者的参与度、治疗依从性和整体结果。

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