Articoli originali
13 febbraio 2025
V. 13 (2025)
Aderenza alle terapie in pazienti con stenosi carotidea prima/dopo l’arruolamento nello studio CARUSO
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Background: questo lavoro analizza l'aderenza alla terapia medica dei pazienti arruolati in uno studio clinico. L'end-point primario di questo studio è stato quello di valutare se l'arruolamento in uno studio clinico può migliorare l'aderenza alla terapia antiaggregante piastrinica e/o lipidica.
Materiali e Metodi: sono stati considerati i primi 92 pazienti asintomatici con stenosi carotidea ≥50% arruolati nello studio CARUSO. La compliance complessiva al basale al trattamento antiaggregante è stata stratificata in pazienti con buona, media e scarsa aderenza. Risultati: la compliance complessiva alla terapia antiaggregante è risultata buona per 66 pazienti (95,7%) su 69 già in trattamento. È stata riscontrata una correlazione significativa tra la buona aderenza alla terapia farmacologica e la presenza di precedenti eventi cardiovascolari al momento dell'arruolamento: 92,3% (un evento), 84,6% (due eventi), 50% (tre eventi) vs 35,1% di quelli senza eventi (p<0.001). Dopo 6 mesi è stata riscontrata una buona aderenza estesa anche ai pazienti che non avevano avuto eventi precedenti (p=0.083).
Conclusioni: questa ricerca ha evidenziato una tendenza positiva nel miglioramento dell'aderenza alla terapia lipidica (88,3% vs 56,7%, p=0.002) e il mantenimento di un livello elevato (>95%) di aderenza alla terapia antiaggregante, dopo l'arruolamento in uno studio clinico.
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Citations
Società Italiana di Chirurgia Vascolare ed Endovascolare (SICVE). Linea guida: diagnosi e trattamento della patologia steno ostruttiva carotidea extracranica e prevenzione dell'ictus cerebrale. 2021. Available from: https://sicve.it/wp-content/uploads/2022/05/Linea-Guida-261-patologia-carotidea-CNEC.pdf
Cutrona SL, Choudhry NK, Fischer MA, et al. Targeting cardiovascular medication adherence interventions. J Am Pharm Assoc. 2012;52:381-97. DOI: https://doi.org/10.1331/JAPhA.2012.10211
Gomez Sandoval YH, Braganza MV, Daskalopoulou SS. Statin discontinuation in high-risk patients: a systematic review of the evidence. Curr Pharm Des. 2011;17:3669-89. DOI: https://doi.org/10.2174/138161211798220891
Mann DM, Woodward M, Muntner P, et al. Predictors of nonadherence to statins: a systematic review and meta-analysis. Ann Pharmacother. 2010;44:1410-21. DOI: https://doi.org/10.1345/aph.1P150
National Cholesterol Education Program (NCEP). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106:3143-421. DOI: https://doi.org/10.1161/circ.106.25.3143
Brookhart MA, Patrick AR, Schneeweiss S, et al. Physician follow-up and provider continuity are associated with long-term medication adherence: a study of the dynamics of statin use. Arch Intern Med. 2007;167:847-52. DOI: https://doi.org/10.1001/archinte.167.8.847
Aubert RE, Yao J, Xia F, Garavaglia SB. Is there a relationship between early statin compliance and a reduction in healthcare utilization? Am J Manag Care. 2010;16:459-66.
Shroufi A, Powles JW. Adherence and chemoprevention in major cardiovascular disease: a simulation study of the benefits of additional use of statins. J Epidemiol Community Health. 2010;64:109-13. DOI: https://doi.org/10.1136/jech.2009.091033
Krist AH, Davidson KW, Mangione CM, et al. Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: US Preventive Services Task Force Recommendation Statement. JAMA. 2020;324:2069-75. DOI: https://doi.org/10.1001/jama.2020.21749
Giannopoulos A, Kakkos S, Abbott A, et al. Long-term mortality in patients with asymptomatic carotid stenosis: implications for statin therapy. Eur J Vasc Endovasc Surg. 2015;50:573e82. DOI: https://doi.org/10.1016/j.ejvs.2015.06.115
Naylor AR, Ricco J-B, De Borst GJ, et al. Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55:3-81. DOI: https://doi.org/10.1016/j.ejvs.2018.03.023
Aranzulla TC, Piazza S, Ricotti A, et al. Carotid plaque stabilization and regression with evolocumab: rationale and design of the CARUSO study. Catheter Cariovasc Interv. 2021;1;98:E115-21. DOI: https://doi.org/10.1002/ccd.29743
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med. 2010;7:e1000251. DOI: https://doi.org/10.1371/journal.pmed.1000251
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-97. DOI: https://doi.org/10.1056/NEJMra050100
Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86:304-14. DOI: https://doi.org/10.4065/mcp.2010.0575
Adams JR, Elwyn G, Legare F, Frosch DL. Communicating with physicians about medical decisions: a reluctance to disagree. Arch Intern Med. 2012;172:1184-6. DOI: https://doi.org/10.1001/archinternmed.2012.2360
Doshi JA, Zhu J, Lee BY, et al. Impact of a prescription copayment increase on lipid-lowering medication adherence in veterans. Circulation. 2009;119:390-7. DOI: https://doi.org/10.1161/CIRCULATIONAHA.108.783944
Choudhry NK, Fischer MA, Avorn J, et al. The implications of therapeutic complexity on adherence to cardiovascular medications. Arch Intern Med. 2011;171:814-22. DOI: https://doi.org/10.1001/archinternmed.2010.495
Schedlbauer A, Davies P, Fahey T. Interventions to improve adherence to lipid lowering medication. Cochrane Database Syst Rev. 2010;3:CD004371. DOI: https://doi.org/10.1002/14651858.CD004371.pub3
Nieuwkerk PT, Nierman MC, Vissers MN, et al. Intervention to improve adherence to lipid-lowering medication and lipid-levels in patients with an increased cardiovascular risk. Am J Cardiol. 2012;110:666-72. DOI: https://doi.org/10.1016/j.amjcard.2012.04.045
Gaw A, Tolmie E, Lindsay GM. The statin breakthrough—remembering to involve the patient. Cardiovasc Drugs Ther. 2004;18:343-4. DOI: https://doi.org/10.1007/s10557-005-5057-9
Yilmaz MB, Pinar M, Naharci I, et al. Being well-informed about statin is associated with continuous adherence and reaching targets. Cardiovasc Drugs Ther. 2005;19:437-40. DOI: https://doi.org/10.1007/s10557-005-5202-5
O’Malley PG. On motivating patients: a picture, even if worth a thousand words, is not enough. Arch Intern Med. 2012;172:309-10. DOI: https://doi.org/10.1001/archinternmed.2011.1948
Golomb BA, McGraw JJ, Evans MA, Dimsdale JE. Physician response to patient reports of adverse drug effects: implications for patient-targeted adverse effect surveillance. Drug Saf. 2007;30:669-75. DOI: https://doi.org/10.2165/00002018-200730080-00003
Golomb BA, Yang E, Denenberg J, Criqui MH. Statin-associated adverse effects. Circulation. 2003;107:e7028-9.
Come citare
Aderenza alle terapie in pazienti con stenosi carotidea prima/dopo l’arruolamento nello studio CARUSO. (2025). Working Paper of Public Health, 13. https://doi.org/10.4081/wpph.2025.10073
Copyright (c) 2025 Michela Lanza, Tiziana Aranzulla, Antonella Cassinari, Giuseppe Musumeci, Andrea Gaggiano, Marianna Farotto, Carlotta Bertolina, Marinella Bertolotti, Antonio Maconi, Alberto Guagliano
Questo volume è pubblicato con la licenza Creative Commons Attribuzione - Non commerciale 4.0 Internazionale.