Exploring the Other Side of Medication: A Patient Interview Study on Anti-PCSK9 Monoclonal Antibodies

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors demonstrate significant lipid-lowering effects, but the widespread use of anti-PCSK9 monoclonal antibodies remains limited.

This study is aimed at understanding patients' real-world experiences with anti-PCSK9 monoclonal antibodies from a subjective perspective and identifying key factors influencing medication adherence.

A qualitative research methodology was employed, involving face-to-face semistructured in-depth interviews with 24 individuals who had previously used anti-PCSK9 monoclonal antibodies. The interviews were guided by a thematic framework approach and recorded in their entirety. Posttranscription, Colaizzi's phenomenological analysis method was utilized to systematically collect and interpret patient-reported subjective experiences.

Among those continuing treatment, the most common motivating factors were the anti-PCSK9 monoclonal antibodies' favorable efficacy and fewer adverse reactions. Among those discontinuing treatment, the primary reasons for stopping were high medication costs (62.5%), insufficient recognition of the necessity for continued use (62.5%), and unwillingness to use injection administration (68.75%). The underlying determinants of patients' behavioral patterns can be elucidated and mitigated by applying the health belief model and the theory of planned behavior.

Research findings indicate that patients' willingness to use medication is primarily influenced by three factors: perceived good efficacy, health awareness, and fear of needles and economic burden. We are aimed at enhancing long-term clinical benefits for patients and improving treatment adherence, establishing education about drug efficacy and necessity, promoting innovation of nasal spray or long-acting implant formulations, and achieving precise medical insurance coverage for high-risk populations.

ChiCTR registration number: ChiCTR2500101339.