Clinician-Patient Risk Discussion for Atherosclerotic Cardiovascular Disease Prevention

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:65

Review

Martin, Seth S.¹  Sperling, Laurence S.²  Blaha, Michael J.¹  Wilson, Peter W. F.²  Gluckman, Ty J.^1,3  Blumenthal, Roger S.¹  Stone, Neil J.⁴ 

[1] Johns Hopkins Univ, Sch Med, Dept Med, Ciccarone Ctr Prevent Heart Dis,Div Cardiol, Baltimore, MD 21205 USA

[2] Emory Univ, Sch Med, Div Cardiol, Dept Med, Atlanta, GA 30322 USA

[3] Providence Heart & Vasc Inst, Portland, OR USA

[4] Northwestern Univ, Dept Med, Div Cardiol, Feinberg Sch Med, Chicago, IL 60611 USA

关键词: cerebrovascular disease;    coronary heart disease;    lipid-lowering therapy;    myocardial infarction;    risk estimation;    shared decision making;   

DOI  :  10.1016/j.jacc.2015.01.043

来源: Elsevier

【 摘 要 】

Successful implementation of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines hinges on a clear understanding of the clinician-patient risk discussion (CPRD). This is a dialogue between the clinician and patient about potential for atherosclerotic cardiovascular disease risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences. Designed especially for primary prevention patients, this process of shared decision making establishes the appropriateness of a statin for a specific patient. CPRD respects the autonomy of an individual striving to make an informed choice aligned with personal values and preferences. Dedicating sufficient time to high-quality CPRD offers an opportunity to strengthen clinician-patient relationships, patient engagement, and medication adherence. We review the guideline-recommended CPRD, the general concept of shared decision making and decision aids, the American College of Cardiology/American Heart Association Risk Estimator application as an implementation tool, and address potential barriers to implementation. (C) 2015 by the American College of Cardiology Foundation.

【 授权许可】

Free