Svilaas A, Bye P, Strøm E C, Kolbjørnsen O, Tonstad S, Ose L
Medisinsk avdeling A Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 1997 Nov 20;117(28):4065-9.
107 patients with primary hypercholesterolaemia participated for five years in a clinical trial with dietary and drug treatment (a statin) at the Lipid Clinic. At the end of the study the patients were referred back to their own physicians, with written advice on diet and drug therapy. At a recall two years later we studied to what extent recommended therapy and follow-up had been implemented. 15% had no follow-up after participating in the study and 18% had not measured their cholesterol for one year or more. The majority of the patients did not follow the recommended diet and level of physical activity satisfactorily, and 20% had stopped their lipid-lowering medication. In general they had been prescribed too low doses of the lipid-lowering agent, and 70% of the patients had not reached the target of the LDL-cholesterol. In conclusion, adequate treatment and a five-year follow-up is not sufficient to keep the patient compliant when the follow-up becomes less intensive. When a clinical trial is terminated, greater efforts should be made to secure better compliance to therapy.
107名原发性高胆固醇血症患者在脂质诊所参加了一项为期五年的饮食和药物治疗（一种他汀类药物）临床试验。研究结束时，患者被转回各自的医生处，并收到关于饮食和药物治疗的书面建议。在两年后的回访中，我们研究了推荐治疗和随访的实施程度。15%的患者在参加研究后没有接受随访，18%的患者一年或更长时间没有测量胆固醇。大多数患者没有令人满意地遵循推荐的饮食和体育活动水平，20%的患者停止了降脂药物治疗。总体而言，他们被开的降脂药剂量过低，70%的患者未达到低密度脂蛋白胆固醇目标。总之，当随访强度降低时，充分的治疗和五年的随访不足以使患者保持依从性。当一项临床试验结束时，应做出更大努力以确保更好的治疗依从性。
