对心力衰竭多药丸策略的患者观点:一个融合并行混合方法研究,嵌入随机临床试验
Neil Keshvani1, Juan David Coellar2, Meera Patel3
1Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, TX; Baylor Scott and White Research Institute, Dallas, TX and Baylor Scott and White The Heart Hospital, Plano, TX.
Circulation. Cardiovascular quality and outcomes
|November 10, 2025
概括
心力衰竭多药在社会经济弱势群体中表现出较高的患者兴趣和接受度,这表明它们可以提高对指南导向医学治疗 (GDMT) 的坚持,并减少药物负担.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 针对心力衰竭与减少喷射率 (HFrEF) 的指南导向医学治疗 (GDMT) 尚未得到充分利用,特别是在弱势群体中.
- 多种药 (组合药) 可能提高GDMT的处方和患者的坚持.
- 了解患者对多种药物实施的看法对于有效的策略至关重要.
研究的目的:
- 探索患者对使用HFrEF多药丸的障碍和促进因素的观点.
- 为了评估患者的兴趣和感知多药药剂方法的坚持益处.
主要方法:
- 一项混合方法研究,涉及焦点小组和对HFrEF患者和随机对照试验 (POLY-HF) 的护理人员的调查.
- 在社会生态框架内使用定向内容分析分析的定性数据.
- 定量数据描述了药物负担和多种药物的偏好.
主要成果:
- 参与者报告了显著的药物负担 (58%服用≥6种药物) 和错过的剂量 (50%).
- 报告称,对改善坚持的多种药物有很高的兴趣 (88.6%) 和信心 (83%).
- 障碍物包括药片大小和含量不确定性;促进因素包括降低药片负担和护理人员支持. 成本是一个系统级的障碍.
结论:
- 在社会经济上处于不利地位的HFrEF患者中,多药丸策略得到了很好的接受.
- 这些发现支持进一步研究多药剂的实施,以改善GDMT的遵守和结果.
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