Experiences of People Diagnosed with High Levels of LDL Cholesterol and Atherosclerotic Cardiovascular Disease: Results from a Multinational Qualitative Study.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Global Heart Pub Date : 2025-07-15 eCollection Date: 2025-01-01 DOI:10.5334/gh.1441
Neil Johnson, Joe Vandigo, Fernanda de Carvalho, Celina Gorre, Tanya Hall, Susan E Hennessy, Dhruv S Kazi, Kornelia Kotseva, Patsy Petrie, David Kelly, Ankita Saxena, Elisabeth M Oehrlein
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引用次数: 0

Abstract

Background: Elevated low-density lipoprotein cholesterol (LDL-C) levels are a leading risk factor for atherosclerotic cardiovascular disease (ASCVD), a major global cause of illness and death. Patients' qualitative insights about experiences, priorities, and needs are essential for creating more targeted, patient-centered quality improvement interventions.

Objectives: To document the experiences of people with high levels of low-density LDL-C in three countries.

Methods: Qualitative study of 60-min in-depth interviews with 50 adult patients from Australia, Brazil, and the United States. The study was overseen by a Steering Committee comprising patients, patient advocates, researchers, and cardiologists. The interviews explored pathways and barriers to high LDL-C diagnosis; the burden of managing high LDL-C and the awareness of the association between high LDL-C and cardiovascular risks. The data were analyzed by applying a structured, team-based approach to coding qualitative data.

Results: There were three main pathways to diagnosing high cholesterol: routine physical exams conducted by primary care providers; symptomatic presentations or incidental findings during emergency visits and through a healthcare visit for another condition, frequently diabetes. Healthcare providers' communication styles influenced patients' perceptions of their conditions. Two-thirds of participants (n = 33) attempted lifestyle changes after their high cholesterol diagnosis, but work schedules and daily routines posed barriers to maintaining healthy habits. Some participants who experienced ASCVD events waited hours or days before seeking care, assuming their symptoms were not serious. After diagnosis of an ASCVD event, many patients feared death and worried about their families' futures. When asked about potential improvements to their current therapy, 21 patients mentioned reduced administration frequency.

Conclusions: This pilot study provides insights into patients' experiences living with and managing elevated LDL-C. It describes opportunities for policymakers and healthcare providers to improve the detection of elevated LDL-C and support patients in understanding risks and strategies for reducing the risk of ASCVD events.

诊断为高水平LDL胆固醇和动脉粥样硬化性心血管疾病的人的经历:来自多国定性研究的结果
背景:低密度脂蛋白胆固醇(LDL-C)水平升高是动脉粥样硬化性心血管疾病(ASCVD)的主要危险因素,ASCVD是全球主要的疾病和死亡原因。患者对经验、优先事项和需求的定性见解对于创建更有针对性、以患者为中心的质量改善干预措施至关重要。目的:记录三个国家高水平低密度LDL-C人群的经历。方法:对来自澳大利亚、巴西和美国的50例成年患者进行60分钟的深度访谈,定性研究。该研究由一个指导委员会监督,该委员会由患者、患者倡导者、研究人员和心脏病专家组成。访谈探讨了高LDL-C诊断的途径和障碍;管理高LDL-C的负担以及对高LDL-C与心血管风险之间关系的认识。对数据进行分析的方法是采用结构化的、基于团队的方法对定性数据进行编码。结果:高胆固醇的诊断主要有三种途径:由初级保健提供者进行常规体检;在急诊就诊期间或通过其他疾病(通常是糖尿病)的保健就诊时出现症状或偶然发现。医疗保健提供者的沟通方式影响患者对其病情的看法。三分之二的参与者(n = 33)在诊断出高胆固醇后试图改变生活方式,但工作安排和日常生活习惯对保持健康习惯构成了障碍。一些经历ASCVD事件的参与者等待数小时或数天才寻求治疗,认为他们的症状并不严重。在诊断出ASCVD事件后,许多患者害怕死亡并担心他们家庭的未来。当被问及当前治疗的潜在改进时,21名患者提到减少了给药频率。结论:这项初步研究提供了对患者生活和处理高LDL-C的经验的见解。它描述了决策者和医疗保健提供者改善LDL-C升高检测的机会,并支持患者了解风险和降低ASCVD事件风险的策略。
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来源期刊
Global Heart
Global Heart Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.70
自引率
5.40%
发文量
77
审稿时长
5 weeks
期刊介绍: Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.
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