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首页> 外文期刊>Patient Preference and Adherence >Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed
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Attitudes toward anticoagulant treatment among nonvalvular atrial fibrillation patients at high risk of stroke and low risk of bleed

机译：中风风险高，出血风险低的非瓣膜性房颤患者对抗凝治疗的态度

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Background: Atrial fibrillation (AF) is associated with an increased risk of stroke. Anticoagulant (AC) therapies are effective at treating AF, but carry with them an increased risk of bleed. Research suggests that a large proportion of AF patients who have high risk of stroke and low risk of bleeding are not currently receiving AC treatment. The goal of this study was to understand the reasons why these patients do not engage in this potentially life-saving treatment. Method: Through a self-report online survey, using validated instruments, 1,184 US adults who self-reported a diagnosis of AF were screened for the risk of stroke and bleed. Of these patients, 230 (19.4%) were at high risk of stroke, low risk of bleed, and not currently using an AC treatment, and were asked follow-up questions to assess their reasons for nontreatment, attitudes toward treatment, and attitudes toward dosing regimens. Results: The most common reasons patients stopped AC treatment were concerns regarding bleeding (27.8%) and other medical concerns (26.6%), whereas the most common reason cited for not being prescribed an AC in the first place was the use of antiplatelet therapy as an alternative (57.1%). In both cases, potentially erroneous decisions regarding perceived stoke and/or bleeding risk were also a factor. Finally, the largest factors regarding attitudes toward treatment and dosing regimen were instructions from an authority figure (eg, physician, pharmacist) and ease of use, respectively. Conclusion: Results suggest that many AF patients who are at high risk of stroke but at low risk of bleed may not be receiving AC due to potentially inaccurate beliefs about risk. This study also found that AF patients place trust in physicians above other factors such as cost when making treatment decisions. Increased education of patients by physicians on the risks and benefits may be a simple strategy to improve outcomes.
机译：背景：房颤（AF）与中风的风险增加相关。抗凝（AC）疗法可有效治疗房颤，但伴有出血的风险增加。研究表明，大部分中风风险高而出血风险低的房颤患者目前未接受AC治疗。这项研究的目的是了解为什么这些患者不进行这种可能挽救生命的治疗的原因。方法：通过一项在线自我报告调查，使用经过验证的仪器，对1,184位自我报告为房颤的美国成年人进行了筛查，以发现中风和出血的风险。在这些患者中，有230名（19.4％）患有中风的高风险，低出血的风险且当前未使用AC治疗，并被问及随访问题以评估其不治疗的原因，治疗态度和态度给药方案。结果：患者停止AC治疗的最常见原因是对出血的担忧（27.8％）和其他医学方面的担忧（26.6％），而首先被拒绝服用AC的最常见原因是使用抗血小板治疗，另一种选择（57.1％）。在这两种情况下，有关感觉中风和/或出血风险的潜在错误决定也是一个因素。最后，关于治疗态度和给药方案的最大因素分别是权威人士（例如医师，药剂师）的指示和易用性。结论：结果表明，由于潜在的关于风险的不正确信念，许多高中风风险但低出血风险的AF患者可能未接受AC。这项研究还发现，房颤患者在做出治疗决定时比其他因素（例如费用）对医生的信任度更高。医生增加对患者的风险和收益的教育可能是提高治疗效果的简单策略。

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