测量他汀类药物在心血管二级预防中的依从性的方法和效度指标:一项系统综述。

IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Adriana López-Pineda, María Martinez-Muñoz, Rauf Nouni-García, Amanda Esquerdo-Arroyo, Álvaro Carbonell-Soliva, Elizabeth Ramirez-Familia, Mª Isabel Tomás-Rodríguez, Jose A Quesada, Concepción Carratalá-Munuera C, Vicente F Gil-Guillén
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引用次数: 0

摘要

背景:坚持他汀类药物治疗对于减少心血管事件的复发至关重要。有许多方法可以衡量药物依从性,包括基于处方数据、患者自我报告、药物计数和直接方法的方法。重要的是要确定哪些方法适合在临床实践中使用。本系统综述旨在确定用于测量心血管二级预防患者他汀类药物依从性和持久性的方法,并评估这些方法的有效性指标。方法:本系统综述纳入了测量他汀类药物在心血管二级预防中的依从性和/或持久性的研究。检索了Medline、Embase和Scopus数据库,检索时间从创建到2025年2月。Rayyan用于研究选择和提取数据过程。收集坚持/坚持方法的效度指标;据报道。使用COSMIN(基于共识的健康测量工具选择标准)工具评估报告方法有效性的研究的偏倚风险。结果:共纳入77项研究。在依从性测量方面,最常用的方法是处方补充记录法(n = 55)和自我报告法(n = 20)。电子监测方法(n = 2)、医生自我感知依从性方法(n = 1)和药片计数方法(n = 1)使用频率较低。直接法采用HPLC-MS/MS,与其他间接法联合使用(n = 5)。为了测量持久性,处方补充记录是主要的方法(n = 9),而自我报告方法在三个研究中使用,一个研究使用标准化问卷。几种间接方法具有衡量不同研究人群和不同药物依从性的效度指标。只有一项研究为专门适用于他汀类药物的MAT问卷提供了效度指标。结论:测量他汀类药物在心血管二级预防中的依从性的方法主要是间接的,依赖于处方和供应记录以及自我报告方法。药片计数、电子监测和LC-MS/MS直接计量较少使用。持久性主要通过处方补充记录来衡量。所有间接方法均未得到验证;因此,不推荐使用它们来衡量他汀类药物的依从性。需要新的有效工具,包括性别视角,来衡量这一人群对他汀类药物的依从性。系统评价注册:PROSPERO CRD42023463981。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Methods and validity indicators for measuring adherence to statins in secondary cardiovascular prevention: a systematic review.

Background: Adherence to statin therapy is crucial for reducing the recurrence of cardiovascular events. Numerous methods exist to measure medication adherence, including those based on prescription data, patient self-report, medication counting, and direct methods. It is important to determine which of these methods are appropriate for use in clinical practice. This systematic review aimed to identify the methods used to measure adherence and persistence to statins in patients undergoing cardiovascular secondary prevention and to evaluate the validity indicators of these methods.

Methods: This systematic review included studies reporting methods to measure adherence and/or persistence to statins in cardiovascular secondary prevention. Medline, Embase, and Scopus databases were searched from inception to February 2025. Rayyan was used for the study selection and extraction data processes. Validity indicators of the adherence/persistence methods were collected; it was reported. Risk of bias of studies reporting the method validity was evaluated using the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool.

Results: A total of 77 studies were included. Regarding adherence measurement, the most frequently used method was prescription refill records (n = 55) and self-report methods (n = 20). Electronic monitoring methods (n = 2), self-perceived adherence by physician (n = 1), and pill counting (n = 1) were less frequently used methods. Direct methods, using HPLC-MS/MS, were used in combination with other indirect methods (n = 5). For measuring persistence, prescription refill records were the predominant method (n = 9), while self-report methods were used in three studies, and one study used a standardized questionnaire. Several of the indirect methods have validity indicators for measuring adherence in different study populations and to different medications. Only one study provides validity indicators for the MAT questionnaire specifically adapted for statins.

Conclusions: The methods for measuring adherence to statins in secondary cardiovascular prevention were predominantly indirect, relying on prescription and supply records and self-report methods. Pill counting, electronic monitoring, and direct measurement via LC-MS/MS were less commonly used. Persistence was primarily measured through prescription refill records. None of the indirect methods was validated; thus, their use for measuring adherence to statins is not recommended. There is a need for new validated tools, incorporating a gender perspective, to measure adherence to statins in this population.

Systematic review registration: PROSPERO CRD42023463981.

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来源期刊
Systematic Reviews
Systematic Reviews Medicine-Medicine (miscellaneous)
CiteScore
8.30
自引率
0.00%
发文量
241
审稿时长
11 weeks
期刊介绍: Systematic Reviews encompasses all aspects of the design, conduct and reporting of systematic reviews. The journal publishes high quality systematic review products including systematic review protocols, systematic reviews related to a very broad definition of health, rapid reviews, updates of already completed systematic reviews, and methods research related to the science of systematic reviews, such as decision modelling. At this time Systematic Reviews does not accept reviews of in vitro studies. The journal also aims to ensure that the results of all well-conducted systematic reviews are published, regardless of their outcome.
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