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Factors Influencing Provider and Patient Choice of P2Y12 Inhibitor Therapy.
- Source :
- Journal of Pharmacy Practice; Apr2022, Vol. 35 Issue 2, p235-243, 9p
- Publication Year :
- 2022
-
Abstract
- Background: Clopidogrel is the most commonly prescribed P2Y<subscript>12</subscript> inhibitor for acute coronary syndrome (ACS) or stent placement, though ticagrelor or prasugrel may be preferred. Medication-related factors may influence selection of therapy. Objectives: To determine which factors most greatly influence cardiology-provider and patient selection of P2Y<subscript>12</subscript> inhibitor to guide shared-decision making (SDM). Methods: Single-center study assessed survey responses from 32 cardiology-providers who prescribed and 105 patients who received clopidogrel, prasugrel, or ticagrelor for ACS or stent placement. Respondents ranked factors influencing P2Y<subscript>12</subscript> inhibitor selection and reported preference of therapy. Patients reported experience with shared decision-making process. Results: Cardiology-providers ranked risk of bleeding, comfort/experience, and cost as most influential. Patients ranked risk of drug interaction, adverse effects, and reduction in myocardial infarction as most influential. Significant differences between cardiology-providers and patients were found for 5 of 8 factors. Cardiology-providers ranked once daily administration (p = 0.01), risk of bleeding (p = 0.002), and cost (p < 0.001) as more important than patients. Patients ranked risk of adverse effects (p = 0.007) and drug interactions (p = 0.005) as more important than cardiology-providers. Cardiology-providers prescribed ticagrelor 42.3% of the time following ACS, though 78.1% ranked it as their preferred agent. Patients were prescribed ticagrelor 9.3% of the time, though 55.7% ranked it as their preferred agent. Use of SDM was reported by 21.6% of patients and 88.5% were unaware that multiple P2Y<subscript>12</subscript> inhibitors existed. Conclusion: Significant differences exist between cardiology-providers and patients regarding factors influencing P2Y<subscript>12</subscript> inhibitor selection, specifically safety-related factors, once daily administration, and cost. Most patients were not involved in SDM. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08971900
- Volume :
- 35
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of Pharmacy Practice
- Publication Type :
- Academic Journal
- Accession number :
- 156614459
- Full Text :
- https://doi.org/10.1177/0897190020966174