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Engebretsen I, Bugge C, Støvring H, Husebye E, Sverre E, Dammen T, Halvorsen S, Munkhaugen J. Treatment patterns and adherence to lipid-lowering drugs during eight-year follow-up after a coronary heart disease event. Atherosclerosis 2024; 393:117550. [PMID: 38657552 DOI: 10.1016/j.atherosclerosis.2024.117550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS Proper prescription and high adherence to intensive lipid lowering drugs (LLD) in patients with coronary heart disease (CHD) are crucial and strongly recommended. The aim of this study is to investigate long-term treatment patterns and adherence to LLD following hospitalization for a CHD event. METHODS Patients admitted to two Norwegian hospitals with a CHD event from 2011 to 2014 (N = 1094) attended clinical examination and completed a questionnaire, median 16 months later. Clinical data were linked to pharmacy dispensing data from 2010 to 2020. The proportions using high-intensity statin therapy (atorvastatin 40/80 mg or rosuvastatin 20/40 mg) and non-statin LLD after the CHD event were assessed. Adherence was evaluated by proportion of days covered (PDC) and gaps in treatment. RESULTS Median age at hospitalization was 63 (IQR 12) years, 21 % were female. Altogether, 1054 patients (96 %) were discharged with a statin prescription, while treatment was dispensed in 85 % within the following 90 days. During median 8 (SD 2.5) years follow-up, the proportion using high-intensity statin therapy ranged 62-68 %, whereas the use of ezetimibe increased from 4 to 26 %. PDC <0.8 was found in 22 % of statin users and 26 % of ezetimibe users. The proportions with a treatment gap exceeding 180 days were 22 % for statins and 28 % for ezetimibe. Smoking at hospitalization and negative affectivity were significantly associated with reduced statin adherence, regardless of adherence measure. CONCLUSIONS In this long-term follow-up of patients with CHD, less than 70 % used high-intensity statin therapy with only small changes over time, and only 25 % used additional treatment with ezetimibe. We identified factors associated with reduced statin adherence that may be target for interventions.
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Affiliation(s)
- Ingrid Engebretsen
- Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372, Oslo, Norway; Oslo Economics, Klingenberggata 7A, 0161, Oslo, Norway; Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 28, 3004, Drammen, Norway.
| | | | - Henrik Støvring
- Oslo Economics, Klingenberggata 7A, 0161, Oslo, Norway; Steno Diabetes Center Aarhus, Paalle Juul-Jensens Blvd. 11, 8200, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Høegh-Guldbergs Gade 10, 8000, Aarhus, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
| | - Einar Husebye
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 28, 3004, Drammen, Norway
| | - Elise Sverre
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 28, 3004, Drammen, Norway; Department of Cardiology, Oslo University Hospital Ullevål, Kirkeveien 166, 0450, Oslo, Norway
| | - Toril Dammen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway; Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Sognsvannsveien 21, 0372, Oslo, Norway
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital Ullevål, Kirkeveien 166, 0450, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway
| | - John Munkhaugen
- Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372, Oslo, Norway; Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 28, 3004, Drammen, Norway
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Perros P, Nagy EV, Papini E, Abad-Madroñero J, Lakwijk P, Poots AJ, Mols F, Hegedüs L. Hypothyroidism and Type D Personality: Results From E-MPATHY, a Cross-sectional International Online Patient Survey. J Clin Endocrinol Metab 2024:dgae140. [PMID: 38591918 DOI: 10.1210/clinem/dgae140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Indexed: 04/10/2024]
Abstract
CONTEXT Between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism. The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor health status and symptom burden but has not been studied in people with hypothyroidism. OBJECTIVE To investigate type D personality in hypothyroidism and explore associations with other characteristics and patient-reported outcomes. DESIGN Multinational, cross-sectional survey. SETTING Online. PARTICIPANTS Individuals with self-reported, treated hypothyroidism. INTERVENTION Questionnaire. MAIN OUTCOME MEASURES Type D personality and associations with baseline characteristics, control of the symptoms of hypothyroidism by medication, satisfaction with care and treatment of hypothyroidism, impact of hypothyroidism on everyday living. RESULTS A total of 3915 responses were received, 3523 of which were valid. The prevalence of type D personality was 54.2%. Statistically significant associations were found between type D personality and several respondent characteristics (age, marital status, ethnicity, household income, comorbidities, type of treatment for hypothyroidism, most recent TSH level), anxiety, depression, somatization, poor control of the symptoms of hypothyroidism by medication, dissatisfaction with care and treatment of hypothyroidism, and a negative impact of hypothyroidism on everyday living). DISCUSSION Our study found a high prevalence of type D personality among people with hypothyroidism who responded to the survey. Type D personality may be an important determinant of dissatisfaction with treatment and care among people with hypothyroidism. Our findings require independent confirmation. Close collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing our understanding in this area.
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Affiliation(s)
- Petros Perros
- Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Endre Vezekenyi Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen 4032, Hungary
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome 00041, Italy
| | - Juan Abad-Madroñero
- Data Science and Insight Team, Picker Institute Europe, Oxford, Oxfordshire OX4 2JY, UK
| | - Peter Lakwijk
- Thyroid Federation International, Transpolispark, Hoofddorp 2132 WT, The Netherlands
| | - Alan J Poots
- Data Science and Insight Team, Picker Institute Europe, Oxford, Oxfordshire OX4 2JY, UK
| | - Floortje Mols
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg 5000 LE, The Netherlands
| | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense 5000, Denmark
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Xu H, Wu C, Xiang S, Qiu S, Chen Y, Takashi E, Yanagihara K, Xie P. Psychosocial markers of pre-hospital delay in patients with diabetic foot: A cross-sectional survey. Nurs Open 2024; 11:e2088. [PMID: 38268288 PMCID: PMC10803947 DOI: 10.1002/nop2.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM This study aimed to determine the psychosocial markers associated with pre-hospital delay among patients with diabetic foot (DF). DESIGN This study has a cross-sectional design. METHODS The participants completed a questionnaire including pre-hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale-14. Bivariate and multivariate analyses were conducted to explore independent associations with pre-hospital delay. RESULTS Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self-management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. PATIENT OR PUBLIC CONTRIBUTION This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China.
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Affiliation(s)
- Huiwen Xu
- School of Nursing & Public HealthYangzhou UniversityYangzhouJiangsuChina
- Nagano College of NursingKomaganeNaganoJapan
| | - Chen Wu
- School of Nursing & Public HealthYangzhou UniversityYangzhouJiangsuChina
| | | | - Shuang Qiu
- Yangzhou Hospital of Traditional Chinese MedicineYangzhouJiangsuChina
| | - Yan Chen
- Northern Jiangsu People's Hospital Affiliated to Yangzhou University/Clinical Medical CollegeYangzhou UniversityYangzhouJiangsuChina
| | - En Takashi
- Nagano College of NursingKomaganeNaganoJapan
| | | | - Ping Xie
- Northern Jiangsu People's Hospital Affiliated to Yangzhou University/Clinical Medical CollegeYangzhou UniversityYangzhouJiangsuChina
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