PDF(Pubmed)
Abstract：
Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers\', including doctors, pharmacists, and nurses, on current lipid management for cardiovascular diseases and prescriptions of novel lipid-lowering therapies, and (ii) to explore the challenges and facilitating factors of prescribing novel lipid-lowering therapies through qualitative interviews. Qualitative semi-structured interviews with twelve medical and non-medical prescribers were conducted, around 20-30 min in length. The interviews were audio-recorded and transcribed on an online platform. A thematic analysis was deployed. Four major themes emerged from the analysis: (1) prescribing barriers; (2) prescribing enablers; (3) inter-profession variability; and (4) health literacy. These themes highlighted the contrast between the need for optimal shared decision making and the various constraints in practice. Participants expressed their inexperience with novel lipid-lowering therapies and acknowledged the requirement and importance of these agents for primary cardiovascular disease prevention. Participants recognised confidence and competence as key drivers for prescribing therapies and welcomed further education and training to enhance their skillset. Patients\' misconceptions towards current lipid-lowering therapies contributed to their refusal of newer agents, highlighting a requirement to improve patient education. Targeting communities through awareness campaigns was identified as a viable solution.
摘要：
降低低密度脂蛋白胆固醇水平可降低动脉粥样硬化性心血管疾病的风险。随着当前和未来的新兴降脂疗法组合被纳入各种国家和国际指南，这项研究的目的是(I)调查英国处方者的看法，包括医生,药剂师,和护士，关于当前心血管疾病的脂质管理和新型降脂疗法的处方，和（ii）通过定性访谈探讨处方新型降脂疗法的挑战和促进因素。对12名医疗和非医疗开处方者进行了定性半结构化访谈，长度约20-30分钟。采访是在在线平台上录音和转录的。进行了专题分析。分析中出现了四个主要主题：（1）处方障碍；（2）处方推动者；（3）行业间差异；（4）健康素养。这些主题强调了最佳共同决策的需要与实践中的各种限制之间的对比。参与者表达了他们对新型降脂疗法的经验不足，并承认这些药物对初级心血管疾病预防的需求和重要性。与会者认识到信心和能力是处方疗法的关键驱动因素，并欢迎进一步的教育和培训，以提高他们的技能。患者对当前降脂疗法的误解导致他们拒绝使用新型药物，强调改善患者教育的要求。通过提高认识运动以社区为目标被认为是一个可行的解决办法。
