1
|
Melendres-Groves L, Tang W, Germack HD, Liu Z, Sadik K. Racial disparities in treatment patterns, healthcare resource use, and outcomes in patients with pulmonary arterial hypertension in the United States. Curr Med Res Opin 2024:1-11. [PMID: 38988262 DOI: 10.1080/03007995.2024.2377682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE This retrospective study using claims data compared demographics, clinical characteristics, treatment patterns, healthcare resource utilization, and clinical outcomes in Black and White patients with pulmonary arterial hypertension (PAH) in the United States. METHODS Patients (aged ≥18 years) had ≥1 pharmacy claim for PAH medication, ≥6 months continuous healthcare plan enrollment, ≥1 inpatient/outpatient medical claim with a pulmonary hypertension diagnosis ≤6 months before first PAH medication, and race recorded. RESULTS This analysis included 836 Black and 2896 White patients. Black patients were younger, with lower levels of education and annual household income, and higher comorbidity scores versus White patients. Only ∼14% of Black and White patients received index combination therapy. Lower adherence to index treatment was observed in Black patients. Although adjusted regression analysis in the overall population showed no differences in outcomes between groups, Black patients <65 years were 36% less likely to receive index combination therapy (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.41-0.99), and 46% less likely to adhere to index treatment (OR 0.54; 95% CI 0.33-0.90). Other disparities included 24% higher all-cause health care resource utilization, 75% higher all-cause costs, and higher risk of clinical composite outcome. Social determinants of health (education, income, health insurance plan) partially mediated these race effects. CONCLUSIONS Differences in demographics, clinical characteristics, and treatment patterns between Black and White patients with PAH were observed. Disparities between Black and White patients <65 years were only partially mediated through social determinants of health variables, suggesting other factors may be involved.
Collapse
Affiliation(s)
- Lana Melendres-Groves
- Division of Pulmonary and Critical Care Medicine, University of New Mexico Health Science Center, Albuquerque, NM, USA
| | - Wenze Tang
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | | | - Zhiwen Liu
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Kay Sadik
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| |
Collapse
|
2
|
Albanell-Fernández M, Mestre MM, López B, González-García R, Planas J, Serrano M, Wilhelmi E, Lizondo T, Soy D, Martín-Conde M. Treatment patterns and factors associated with adherence in pulmonary arterial hypertension. FARMACIA HOSPITALARIA 2024:S1130-6343(24)00055-2. [PMID: 38955664 DOI: 10.1016/j.farma.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE Improving understanding of actual pulmonary hypertension (PH) treatment adherence patterns is crucial to properly treating these patients. We aimed to primarily assess adherence to treatments used for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) specific therapies, identify potential factors related to it and secondly describe its treatment patterns. METHODS A 6-month observational cross-sectional study in a tertiary care hospital was conducted. Patients with PH-targeted therapy who picked it up in the ambulatory hospital pharmacy and who had been on treatment with the same drug for at least 1 year were included. Adherence was assessed as: 1) Proportion of days covered (PDC); and 2) Simplified Medication Adherence Questionnaire (SMAQ). PDC ≥80% was considered adherent. Statistical analyses were performed to evaluate the study outcomes. Logistic regressions were estimated to identify the association between baseline characteristics and factors associated with adherence. P < 0.05 indicated statistical significance. RESULTS A total of 63 patients with 127 different treatments were included, 71.4% were females with a mean age (SD) of 59 (15) years. PAH was the most common diagnosis (74.6%). Double therapy was used in 39.7% of patients, being the combination of Macitentan + Tadalafil and Ambrisentan + Tadalafil the most prescribed. Endothelin receptor antagonists were the most used treatment (40.2%). Adherence according to PDC was 93.7%, showing no great differences depending on the targeted drug used, and according to SMAQ 61.9%. The agreement degree of both methods was slight (65.1%; Kappa 0.12). Only female sex (OR: 0.23, 95% CI: 0.06-0.90; p = 0.035) was associated with worse adherence in the SMAQ method but not in the PDC. Adverse events were reported by a 55.6% of participants and the perception of effective treatment was high (95.2%). CONCLUSIONS Adherence to PH therapy differs depending on the assessment method; PDC showed greater adherence rate than SMAQ. According to SMAQ, female sex may have a negative impact on adherence in this cohort, but PDC revealed no factors influencing it. No notable differences in adherence between treatment types were found and generally patients felt the treatments were effective in controlling their disease.
Collapse
Affiliation(s)
- Marta Albanell-Fernández
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
| | - María Margalida Mestre
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Belén López
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Rubén González-García
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Jaume Planas
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Marta Serrano
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Emma Wilhelmi
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Thais Lizondo
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Dolors Soy
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Department of Pharmacology, Toxicology and Therapeutic Chemistry. School of Pharmacy. University of Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Maite Martín-Conde
- Pharmacy Service, Division of Medicines, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Le Bozec A, Korb-Savoldelli V, Boiteau C, Dechartres A, Al Kahf S, Sitbon O, Montani D, Jaïs X, Guignabert C, Humbert M, Savale L, Chaumais MC. Medication adherence, related factors and outcomes among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension: a systematic review. Eur Respir Rev 2024; 33:240006. [PMID: 38960611 PMCID: PMC11220621 DOI: 10.1183/16000617.0006-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/04/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening conditions that can progress to death without treatment. Although strong medication adherence (MA) is known to enhance outcomes in chronic illnesses, its association with PAH and CTEPH was sporadically explored. This study aims to examine the MA of patients with PAH or CTEPH, identify factors associated with low adherence and explore the resulting outcomes. METHODS A systematic review was conducted by searching multiple databases (Medline, Embase, Cochrane Central, ClinicalTrials.gov, Scopus, Web of Science and Google Scholar) from 6 March 1998 to 6 July 2023. We included studies reporting MA as primary or secondary end-points. Study selection, data extraction and methodological quality assessment were performed in duplicate. RESULTS 20 studies involving 22 675 patients met the inclusion criteria. Heterogeneity was observed, particularly in the methods employed. MA means ranged from 0.62 to 0.96, with the proportion of patients exhibiting high MA varying from 40% (95% CI 35-45%) to 94% (95% CI 88-97%). Factors associated with low adherence included increased treatment frequency, time since diagnosis and co-payment. High MA seems to be associated with reduced hospitalisation rates, inpatient stays, outpatient visits and healthcare costs. CONCLUSIONS This systematic review underscores the heterogeneity of MA across studies. Nevertheless, the findings suggest that high MA could improve patients' clinical outcomes and alleviate the economic burden. Identifying factors consistently associated with poor MA could strengthen educational efforts for these patients, ultimately contributing to improved outcomes.
Collapse
Affiliation(s)
- Antoine Le Bozec
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
| | - Virginie Korb-Savoldelli
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Cité, Service de Pharmacie, Hôpital Européen Georges Pompidou, Paris, France
| | - Claire Boiteau
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1421, Paris, France
| | - Salma Al Kahf
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - David Montani
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Christophe Guignabert
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service de Pneumologie et soins intensifs, centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Marie-Camille Chaumais
- Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Saclay, Service de Pharmacie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Inserm, Hypertension Pulmonaire: Physiopathologie et Innovation Thérapeutique (HPPIT), Le Kremlin-Bicêtre, France
- Université Paris Saclay, Faculté de Pharmacie, Département de Pharmacie Clinique, Université Paris Saclay, Orsay, France
| |
Collapse
|
4
|
Farber HW, Germack HD, Croteau NS, Simeone JC, Tang F, Paoli CJ, Doad G, Panjabi S, De Marco T. Factors associated with discontinuation of treatment for pulmonary arterial hypertension in the United States. Pulm Circ 2024; 14:e12326. [PMID: 38623409 PMCID: PMC11017292 DOI: 10.1002/pul2.12326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 04/17/2024] Open
Abstract
Information on factors leading to pulmonary arterial hypertension (PAH) treatment discontinuation is limited. This study analyzed 12,902 new PAH medication users to identify predictors of treatment discontinuation. Treatment by accredited pulmonary hypertension centers and combination therapy with PAH agents from different classes were less likely to result in discontinuation.
Collapse
Affiliation(s)
- Harrison W Farber
- Division of Pulmonary, Critical Care and Sleep Medicine Tufts Medical Center Boston Massachusetts USA
| | | | | | | | - Fei Tang
- Real World Evidence Cytel Waltham Massachusetts USA
| | - Carly J Paoli
- Janssen Scientific Affairs, LLC Titusville New Jersey USA
| | | | - Sumeet Panjabi
- Janssen Scientific Affairs, LLC Titusville New Jersey USA
| | - Teresa De Marco
- Division of Cardiology University of California, San Francisco San Francisco California USA
| |
Collapse
|
5
|
Kim NH, Chin KM, McLaughlin VV, DuBrock H, Restrepo-Jaramillo R, Safdar Z, MacDonald G, Martin N, Rosenberg D, Solonets M, Channick R. Safety of Macitentan for the Treatment of Portopulmonary Hypertension: Real-World Evidence from the Combined OPUS/OrPHeUS Studies. Pulm Ther 2024; 10:85-107. [PMID: 38184507 PMCID: PMC10881949 DOI: 10.1007/s41030-023-00251-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/14/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Portopulmonary hypertension (PoPH) carries a worse prognosis than other forms of pulmonary arterial hypertension (PAH). Data regarding use of PAH-specific therapies in patients with PoPH are sparse as they are usually excluded from clinical trials. This analysis describes patient characteristics, treatment patterns, outcomes, and safety profiles in patients with PoPH newly initiating macitentan in the USA using the OPUS/OrPHeUS combined dataset. METHODS OPUS was a prospective, US, multicenter, observational drug registry (April 2014-June 2020); OrPHeUS was a retrospective, US, multicenter chart review (October 2013-March 2017). Additional information regarding patients' liver disease was retrospectively collected for patients with PoPH in OPUS. RESULTS The OPUS/OrPHeUS dataset included 206 patients with PoPH (median age 58 years; 52.4% female), with baseline cirrhosis and liver test abnormalities reported in 72.8% and 31.6% of patients respectively. Macitentan was initiated as combination therapy in 74.8% of patients and median (Q1, Q3) exposure to macitentan was 11.9 (3.1, 26.0) months. One-year Kaplan-Meier estimates (95% confidence limit, CL) of patients free from all-cause hospitalization and survival were 48.6% (40.7, 56.0) and 82.2% (75.1, 87.4). Of the 96 patients with PoPH in OPUS, 29.2% were classified as in need of liver transplant due to underlying liver disease during the study; transplant waitlist registration was precluded because of PAH severity for 32.1% and 17.9% were transplanted. Hepatic adverse events (HAE) were experienced by 49.0% of patients; the most common being increased bilirubin (16.0%), ascites (7.3%), and hepatic encephalopathy (5.8%); 1.5% and 21.8% of patients discontinued macitentan as a result of HAE and non-hepatic adverse events. CONCLUSION There were no unexpected safety findings in patients with PoPH treated with macitentan. These data add to the evidence supporting the safety and tolerability of macitentan in patients with PoPH. A graphical abstract is available with this article. TRIAL REGISTRATION OPsumit® Users Registry (OPUS): NCT02126943; OPsumit® Historical Users cohort (OrPHeUS): NCT03197688; www. CLINICALTRIALS gov .
Collapse
Affiliation(s)
- Nick H Kim
- UC San Diego Health, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, 9300 Campus Point Dr, La Jolla, CA, 92037-7381, USA.
| | | | | | | | | | - Zeenat Safdar
- Houston Methodist, Weill Cornell Medical College, Houston, TX, USA
| | - Gwen MacDonald
- Global Medical Affairs, Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Allschwil, Switzerland
| | - Nicolas Martin
- Statistical Decision Science, Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Allschwil, Switzerland
| | - Daniel Rosenberg
- Global Epidemiology, Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Allschwil, Switzerland
| | - Maria Solonets
- Global Medical Safety, Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson and Johnson, Allschwil, Switzerland
| | - Richard Channick
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
6
|
Kan J, Zhang H, Xie D, Wei Y, Zhang J, Zhang C, Yang Z, Gu H, Fan F, Gu H, Wang Q, Zhang G, Guo X, Yin Y, Wang X, Jin B, Zhou H, Yang Z, Wang Z, Xin Y, Zhang C, Meng L, Wang X, Zhao C, Yan X, Chen F, Yao C, Stone GW, Chen SL. A sham-controlled randomised trial of pulmonary artery denervation for Group 1 pulmonary arterial hypertension: one-year outcomes of the PADN-CFDA trial. EUROINTERVENTION 2023; 19:684-694. [PMID: 37458100 PMCID: PMC10587847 DOI: 10.4244/eij-d-23-00349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Long-term clinical outcomes after pulmonary artery denervation (PADN) in patients with Group 1 pulmonary arterial hypertension (PAH) have not been reported. AIMS We aimed to investigate the effect of PADN on 1-year outcomes in patients with PAH. METHODS In the multicentre PADN-CFDA trial, 128 patients with Group 1 PAH were randomly assigned to PADN plus a phosphodiesterase-5 inhibitor (PDE-5i) versus a sham PADN procedure plus a PDE-5i. The principal endpoint of interest for the present study was clinical worsening at 1 year after randomisation, the composite of worsening of PAH (increase in WHO functional class, need for additional PAH treatments or PAH-related hospitalisation), atrial septostomy, listing for lung transplantation, or all-cause death. RESULTS One-year clinical follow-up was available in all patients. At 1 year, clinical worsening had occurred in 3 (4.8%) patients in the PADN plus PDE-5i group and in 15 patients (23.1%) in the sham plus PDE-5i group (adjusted hazard ratio: 0.17; 95% confidence interval [CI]: 0.05-0.60; p=0.006), driven by significantly increased rates of PAH-related hospitalisations, worsening functional class and the requirement for additional PAH treatments in the sham group. Results were consistent in high-risk, intermediate-risk and low-risk patients (pinteraction=0.186). Patients treated with PADN plus PDE-5i had an improvement in the between-group change in the six-minute walking distance (6MWD) from baseline to 1 year of 81.2 m (95% CI: 50.3-112.2; p<0.001) compared with PDE-5i treatment alone. CONCLUSIONS In this multicentre sham-controlled randomised trial, PADN treatment for Group 1 PAH significantly reduced clinical worsening and improved the 6MWD during 1-year follow-up in patients treated with a PDE-5i.
Collapse
Affiliation(s)
- Jing Kan
- Division of Cardiology, Nanjing First Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Hang Zhang
- Division of Cardiology, Nanjing First Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Dujiang Xie
- Division of Cardiology, Nanjing First Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yongyue Wei
- Center for Public Health and Epidemic Preparedness & Response, Health Science Center, Peking University, Shanghai, People's Republic of China
| | - Juan Zhang
- Division of Cardiology, Nanjing First Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Caojin Zhang
- Division of Cardiology, Guangdong Provincial Peoples Hospital, Guangzhou, People's Republic of China
| | - Zhenwen Yang
- Division of Pulmonary Vascular Disease, General Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Heping Gu
- Division of Cardiology, First Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Fenling Fan
- Division of Pulmonary Vascular Disease, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Hong Gu
- Division of Congenital Heart Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Qiguang Wang
- Division of Pulmonary Vascular Disease, General Hospital of Northern Theater of Command, Shenyang, People's Republic of China
| | - Gangcheng Zhang
- Division of Pulmonary Vascular Disease, Zhongnan Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Xiaomei Guo
- Division of Cardiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yuehui Yin
- Division of Cardiology, Second Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiang Wang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Bowen Jin
- Division of Pulmonary Vascular Disease, Wuhan Asia Heart Hospital, Wuhan, People's Republic of China
| | - Hongmei Zhou
- Division of Pulmonary Vascular Disease, Wuhan Asia Heart Hospital, Wuhan, People's Republic of China
| | - Ziyang Yang
- Division of Cardiology, Guangdong Provincial Peoples Hospital, Guangzhou, People's Republic of China
| | - Zhouming Wang
- Division of Pulmonary Vascular Disease, General Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Yu Xin
- Division of Cardiology, First Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Chen Zhang
- Division of Congenital Heart Disease, Beijing Anzhen Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Lili Meng
- Division of Pulmonary Vascular Disease, General Hospital of Northern Theater of Command, Shenyang, People's Republic of China
| | - Xiaoyu Wang
- Division of Pulmonary Vascular Disease, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chunxia Zhao
- Division of Cardiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xiaoyan Yan
- Peking University Clinical Research Institute, Beijing, People's Republic of China
| | - Feng Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Cheng Yao
- Peking University Clinical Research Institute, Beijing, People's Republic of China
| | - Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shao-Liang Chen
- Division of Cardiology, Nanjing First Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| |
Collapse
|
7
|
Braley K, Richardson K, Whitley L, Werner K, Appleby L. Patient perspectives on pulmonary hypertension in the United States: Burdens, expectations, and goals. Pulm Circ 2023; 13:e12247. [PMID: 37346966 PMCID: PMC10279947 DOI: 10.1002/pul2.12247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/20/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
Pulmonary hypertension (PH) is a life-threatening, debilitating disease caused by increased blood pressure in the pulmonary arteries. As patients living in the United States, we have unique insights into the journey from diagnosis and treatment within the US healthcare system and the significant impact that PH has on our quality of life. While there have recently been advances in PH management, there are several areas of PH care which we feel should be reassessed and improved. Commonly, diagnosis is lengthy and convoluted due to the rarity of the disease and limited knowledge of PH in primary care. There are also barriers to obtaining the right treatment and we feel that a more holistic approach to care is needed. Mental health is commonly overlooked and should be an integral part of patient care, as should elements such as nutritional advice, cardiopulmonary rehabilitation, and sexual health. PH patient associations play a key role in providing social, educational, and financial support to patients and caregivers alongside PH research and advocacy. As patients, we feel that we need to advocate for correct diagnosis, timely referral, and optimal treatment, in addition to overcoming the financial and/or administrative hurdles to obtain these. We propose several future goals to help empower patients to play an active, central role in their care and to improve all aspects of PH management. We advocate for further use of the patient voice in research and clinical development programs, including the use of patient-reported outcomes that have been developed with patient input.
Collapse
|