评估传染病医生对 PLWH 血脂异常管理的态度。

Postgraduate medicine Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI:10.1080/00325481.2024.2394015
Fatma Nisa Balli Turhan, Emre Kara, Oğuz Abdullah Uyaroğlu, Nursel Çalık Başaran, Kutay Demirkan, Serhat Ünal, Ahmet Çağkan İnkaya
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摘要

目的:血脂异常是动脉粥样硬化性心血管疾病(ASCVD)的公认风险因素。艾滋病病毒感染者(PLWH)的 ASCVD 患病率是普通人群的两倍。本研究旨在评估传染病(ID)医生对艾滋病病毒感染者血脂异常管理的态度:这项观察性横断面研究在 2023 年 11 月至 2024 年 2 月期间对 ID 医生进行了在线调查。通过当地的 ID 协会向医生发送了一封包含调查链接、标题和研究目的的电子邮件。调查内容包括医生的人口统计学特征及其对 PLWH 血脂异常的治疗态度:共有 242 名医生回复了调查,其中 59.9%(n = 145)为内科专科医生,40.1%(n = 97)为内科住院医生。41%(n = 100)的医生称他们没有遵循指南,26%的医生称他们在临床实践中没有使用心血管风险计算器。与住院医师(43.3%)相比,专科医生(69%)更有可能遵循血脂异常管理的临床指南(p n = 174),73%(n = 177)的医生怀疑是否有必要治疗血脂异常,73%(n = 177)的医生受到患者怀疑态度的影响。68.6%的医生认为工作量大和缺乏时间是实施血脂异常指南建议的障碍:结论:相当多的土耳其内科医生不喜欢使用血脂异常临床指南和 ASCVD 风险计算器。医生开具他汀类药物处方受到工作量、时间不足、患者怀疑和知识缺乏的影响。对 ID 医生进行 ASCVD 初级预防和 PLWH 血脂异常管理方面的培训至关重要。
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Evaluation of infectious diseases physicians' attitudes to dyslipidemia management in PLWH.

Objectives: Dyslipidemia is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD). ASCVD prevalence among people living with HIV (PLWH) is twice that of the general population. This study aimed to evaluate the infectious diseases (ID) physicians' attitudes on dyslipidemia management in PLWH.

Methods: This observational, cross-sectional study was conducted as online survey among ID physicians between November 2023 and February 2024. An e-mail with the survey link, title and purpose of the study was sent to physicians through the local ID societies. The survey included questions about physicians' demographic characteristics and their attitudes toward treating dyslipidemia in PLWH.

Results: A total of 242 physicians responded to the survey, of whom 59.9% (n = 145) were ID specialists and 40.1% (n = 97) were ID residents. Forty-one percent (n = 100) of physicians reported that they did not follow a guideline, and 26% of physicians reported that they did not use a cardiovascular risk calculator in their clinical practice. Specialists (69%) were more likely than residents (43.3%) to follow clinical guidelines for dyslipidemia management (p < 0.001). Seventy-two percent (n = 174) of physicians doubted the need to treat dyslipidemia, and 73% (n = 177) of physicians were affected by the patient skepticism. Workload and lack of time were identified by 68.6% of physicians as barriers to implementing dyslipidemia guideline recommendations.

Conclusion: A considerable number of Turkish ID physicians did not prefer using clinical guidelines for dyslipidemia and ASCVD risk calculators. Statin prescribing of physicians was influenced by workload, lack of time, patient skepticism, and lack of knowledge. Training ID physicians in primary prevention of ASCVD and management of dyslipidemia in PLWH is paramount.

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