Lee Jin Sol G, Choi Yong, Tejuco Kyle, Heng Franklin, Kesarwani Manoj
Department of Internal Medicine, Harbor-UCLA (University of California Los Angeles) Medical Center, Torrance, USA.
Department of Internal Medicine, David Geffen School of Medicine at UCLA (University of California Los Angeles), Los Angeles, USA.
Cureus. 2025 Jun 13;17(6):e85924. doi: 10.7759/cureus.85924. eCollection 2025 Jun.
Background Nonadherence to P2Y12 inhibitor therapy following percutaneous coronary intervention (PCI) is associated with an increased risk of major adverse cardiovascular events. However, there are a variety of factors - intentional and non-intentional - that contribute to P2Y12 inhibitor nonadherence and result in poor patient outcomes. Objective The primary aim of this study was to identify natural, lived experiences of individuals taking P2Y12 inhibitors in the real world, using a widely used social media platform to identify common barriers to medication adherence. Methods Using deidentified data extracted from Twitter (now known as X) from January 1, 2016, to December 31, 2019, user comments pertaining to generic and brand names of P2Y12 inhibitor use were extracted using the GetOldTweets API (Application Programming Interface) with Python. Non-English tweets, duplicates, posts from automated bots, and those from users with clinical titles were excluded. The remaining posts were then manually reviewed based on the following inclusion criteria: (1) discussed treatment with P2Y12 inhibitors, (2) reflected personal experiences with P2Y12 inhibitors (e.g., patient or caregiver), and (3) provided sufficient context for qualitative analysis. A total of 366 eligible posts were analyzed using conventional content analysis and grouped into five key themes, which were further categorized into positive, negative, or neutral sentiments. Results Five representative themes emerged from the data, including adverse drug reactions (137 or 37%), affordability (93 or 25%), inconvenience of taking the medication (77 or 21%), patient-perceived response to treatment (42 or 12%), and provider trust and communication (17 or 5%). Most posts (205 or 56%) expressed negative sentiments (e.g., anger, frustration, sadness, fear) about taking P2Y12 inhibitors, while 26 (7%) shared positive sentiments (e.g., joy, gratitude, happiness, excitement). The remaining 135 (37%) were classified as neutral. Conclusions This study, using natural, lived experiences of users with P2Y12 inhibitors, highlights the complex factors that may contribute to nonadherence to this medication. By better understanding patient attitudes and beliefs regarding this class of medication, as expressed in user comments, barriers to adherence can be identified and form the basis for future studies aimed at developing meaningful interventions to ensure consistent P2Y12 inhibitor use among post-PCI patients.
经皮冠状动脉介入治疗（PCI）后不坚持使用P2Y12抑制剂治疗与主要不良心血管事件风险增加相关。然而，有多种因素——有意和无意的——导致P2Y12抑制剂治疗的不依从，并导致患者预后不良。目的：本研究的主要目的是利用一个广泛使用的社交媒体平台，识别现实世界中服用P2Y12抑制剂的个体的自然生活经历，以确定药物依从性的常见障碍。方法：使用从2016年1月1日至2019年12月31日从推特（现称为X）中提取的去识别化数据，使用带有Python的GetOldTweets应用程序编程接口（API）提取与P2Y12抑制剂使用的通用名和品牌名相关的用户评论。排除非英语推文、重复推文、自动机器人发布的内容以及具有临床头衔的用户发布的内容。然后根据以下纳入标准对其余帖子进行人工审核：（1）讨论了P2Y12抑制剂治疗；（2）反映了使用P2Y12抑制剂的个人经历（如患者或护理人员）；（3）为定性分析提供了足够的背景信息。使用常规内容分析对总共366条符合条件的帖子进行分析，并分为五个关键主题，这些主题进一步分为积极、消极或中性情绪。结果：数据中出现了五个代表性主题，包括药物不良反应（137条，占37%）、可承受性（93条，占25%）、服药不便（77条，占21%）、患者对治疗的感知反应（42条，占12%）以及对医疗服务提供者的信任和沟通（17条，占5%）。大多数帖子（205条，占56%）表达了对服用P2Y12抑制剂的负面情绪（如愤怒、沮丧、悲伤、恐惧），而26条（占7%）分享了积极情绪（如喜悦、感激、幸福、兴奋）。其余135条（占37%）被归类为中性。结论：本研究利用使用P2Y12抑制剂的用户的自然生活经历，突出了可能导致这种药物不依从的复杂因素。通过更好地理解用户评论中表达的患者对这类药物的态度和信念，可以识别依从性障碍，并为未来旨在制定有意义的干预措施以确保PCI术后患者持续使用P2Y12抑制剂的研究奠定基础。
