Patient Treatment Preferences for Heart Failure Medications: A Mixed Methods Study.
Patient Treatment Preferences for Heart Failure Medications: A Mixed Methods Study.
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DOI：
10.2147/ppa.s276328
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发表时间：
2020
影响因子：
2.2
通讯作者：
Matlock DD
中科院分区：
文献类型：
--
作者：
Trinkley KE;Kahn MG;Allen LA;Haugen H;Kroehl ME;Lin CT;Malone DC;Matlock DD
考虑患者对指南导向药物治疗（GDMT）治疗心力衰竭伴射血分数降低（HFrEF）的偏好，可能有助于改善处方和依从性方面的主要差距。本研究旨在确定影响患者决定服用HFrEF药物的因素的范围和相对优先级。这是一项针对HFrEF患者的收敛混合方法研究。进行焦点小组以确定一系列因素，然后由个人对每个因素对他们决定服用药物的影响进行评级和排名。通过主题分析，我们将偏好分类。两个有13名参与者的焦点小组报告了22个因素。在这些因素中，“让你活着”最常见地排在前三位（7名参与者），其次是“沟通和理解”（6名参与者）。这些因素被总结为六类（按患者报告的影响顺序列出）：1)生活质量和寿命的改善，2)住院风险的降低，3)共同决策的机会和对提供者的信任，4)没有不良事件，5)负担得起，6)服用方便且不干扰日常生活。患者优先考虑的是治疗益处和了解情况，而不是服用HFrEF药物的风险、成本和不便。
Consideration of patient preferences for guideline-directed medical therapies (GDMT) for heart failure with reduced ejection fraction (HFrEF) may help improve major gaps in prescribing and adherence. This study aimed to identify the range and relative priority of factors influencing patients’ decisions to take HFrEF medications. This was a convergent mixed methods study of patients with HFrEF. Focus groups were conducted to identify a list of factors followed by individuals rating and ranking the influence of each factor on their decision to take a medication. Using thematic analysis, we summarized preferences into categories. Two focus groups with 13 participants reported 22 factors. Of the factors, “keeping you alive” was most commonly ranked in the top three (seven participants), followed by “communication and understanding” (six participants). Factors were summarized into six categories (listed in order of patient-reported influence): 1) demonstrated improvements in quality of life and longevity, 2) decreased risk of hospitalization, 3) opportunity for shared decision-making and trust in provider, 4) absence of adverse events, 5) affordability, and 6) convenience of taking and absence of interference with daily life. Patients prioritize treatment benefits and being informed more than risks, cost and inconvenience of taking HFrEF medications.