Patient-reported adherence to statin therapy, barriers to adherence, and perceptions of cardiovascular risk.
Patient-reported adherence to statin therapy, barriers to adherence, and perceptions of cardiovascular risk.
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DOI：
10.1371/journal.pone.0191817
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Jaffe MG
中科院分区：
文献类型：
--
作者：
Fung V;Graetz I;Reed M;Jaffe MG
患者报告他们的依从性行为，对他汀类药物的担忧，以及对动脉粥样硬化性心血管疾病（ASCVD）风险的看法，可以为改善他汀类药物治疗依从性的方法提供信息。我们研究了这些因素及其与依从性的关系。2010年，我们对在综合性分娩系统中接受他汀类药物治疗的成年人进行了分层随机抽样电话采访（N = 730，应答率为81%）。我们在三个临床风险类别中抽取了相同数量的个体：1）冠状动脉疾病; 2）糖尿病或其他ASCVD诊断; 3）无糖尿病或ASCVD诊断。我们评估了服用他汀类药物的15个潜在问题和障碍，以及未来10年内心脏病发作的感知风险（0-10级）。我们使用配药数据计算了过去12个月内他汀类药物覆盖的天数比例（PDC），并使用多变量logistic回归分析了与非依从性相关的特征（PDC<80%）。分析按抽样比例加权。PDC<50%的患者中有61%报告在过去12个月内没有填写新处方，拆分或跳过他汀类药物，或停止重新填写他汀类药物，而PDC≥80%的患者中有15%（p<0.05）。最常报告的关于他汀类药物的担忧是更喜欢通过改变生活方式来降低胆固醇（66%），一般不喜欢药物（59%）以及肝脏或肾脏问题（31%）;难以记住服用他汀类药物（9%）是服用少于处方的最常见原因。在多变量分析中，临床风险类别与不依从的几率没有显著相关性;然而，那些感知心脏病发作风险较高的患者不依从的可能性较小。患者报告的服药行为与他汀类药物PDC相关，那些感知心血管风险较低的患者不太可能依从。这些发现强调了从患者那里获得和教育他们的依从性行为和ASCVD风险的重要性。
Patient reports of their adherence behaviors, concerns about statins, and perceptions of atherosclerotic cardiovascular disease (ASCVD) risk could inform approaches for improving adherence to statin therapy. We examined these factors and their associations with adherence. We conducted telephone interviews among a stratified random sample of adults receiving statins within an integrated delivery system (N = 730, 81% response rate) in 2010. We sampled equal numbers of individuals in three clinical risk categories: those with 1) coronary artery disease; 2) diabetes or other ASCVD diagnosis; and 3) no diabetes or ASCVD diagnoses. We assessed 15 potential concerns about and barriers to taking statins, and perceived risk of having a heart attack in the next 10 years (0–10 scale). We calculated the proportion of days covered (PDC) by statins in the last 12 months using dispensing data and used multivariate logistic regression to examine the characteristics associated with non-adherence (PDC<80%). Analyses were weighted for sampling proportions. Sixty-one percent of patients with PDC<50% reported not filling a new prescription, splitting or skipping statins, or stopping refilling statins in the last 12 months vs. 15% of those with PDC≥80% (p<0.05). The most commonly reported concerns about statins were preferring to lower cholesterol with lifestyle changes (66%), disliking medications in general (59%), and liver or kidney problems (31%); having trouble remembering to take statins (9%) was the most common reason for taking less than prescribed. In multivariate analyses, clinical risk categories were not significantly associated with odds of non-adherence; however, those with higher perceived risk of heart attack were less likely to be non-adherent. Patient-reported medication-taking behaviors were correlated with statin PDC and those with lower perceived cardiovascular risk were less likely to be adherent. These findings highlight the importance of eliciting from and educating patients on their adherence behaviors and ASCVD risks.
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影响因子：
3.5
作者：
Kuntz JL;Safford MM;Singh JA;Phansalkar S;Slight SP;Her QL;Lapointe NA;Mathews R;O'Brien E;Brinkman WB;Hommel K;Farmer KC;Klinger E;Maniam N;Sobko HJ;Bailey SC;Cho I;Rumptz MH;Vandermeer ML;Hornbrook MC
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通讯作者：
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通讯作者：
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影响因子：
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通讯作者：
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影响因子：
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Ledwidge, Mark