Why do patients with systemic lupus erythematosus take or fail to take their prescribed medications A qualitative study in a UK cohort
Why do patients with systemic lupus erythematosus take or fail to take their prescribed medications A qualitative study in a UK cohort
复制标题
DOI：
10.1093/rheumatology/ken479
复制
发表时间：
2009-03-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, D.
中科院分区：
文献类型：
--
作者：
Chambers, S. A.;Raine, R.;Isenberg, D.
Objective.有研究表明，低依从性可能导致SLE患者的临床结局较差。在这项研究中，我们探讨了狼疮患者是否按规定服用药物的原因。包括10厘米视觉模拟量表（VAS），以评估自我报告的处方药物的依从性分发给315例SLE患者。这些回答被用来选择一个有目的的样本，这些样本参加了访谈，讨论他们为什么服用或不服用药物。在315例患者中，220（70）例完成了问卷调查。33名患者接受了采访。解释患者定期服药的原因的主题包括：害怕疾病恶化，认为没有有效的治疗替代处方药物，缺乏对SLE的了解，从而对改变药物和道德义务或对他人的责任感充满信心。解释患者为什么不定期服药的主题包括：相信狼疮可以而且应该使用替代方法控制，相信长期使用药物是没有必要的，担心药物的不良反应，在获得药物的实际困难，以及患者和医生之间的沟通不畅。患者服用或不服用药物的原因主要与以前的疾病和/或药物经历有关。然而，改善医生和患者之间的沟通可能会促进SLE患者更好的依从性。
Objective. It has been suggested that low adherence may contribute to poor clinical outcomes in patients with SLE. In this study, we explored the reasons why patients with lupus did or did not take their medications as prescribed.Methods. Questionnaires including a 10-cm visual analogue scale (VAS) to assess self-reported adherence to prescribed medications were distributed to 315 patients with SLE. The responses were used to select a purposive sample of subjects who participated in interviews to discuss why they did or did not take their medications.Results. Of the 315 patients, 220 (70) completed the questionnaire. Thirty-three patients were interviewed. Themes explaining why patients took their medications regularly included: the fear of worsening disease, the belief that there was no effective therapeutic alternative to their prescribed medications, lack of knowledge about SLE to allow confidence in changing medications and feelings of moral obligation or responsibility to others. Themes explaining why patients did not take their medications regularly included: the belief that lupus could and should be controlled using alternative methods, the belief that long-term use of drugs was not necessary, the fear of drug adverse effects, practical difficulties in obtaining medications, and poor communication between patients and doctors.Conclusion. The patients reasons for taking or not taking their medications largely related to previous experiences with the disease and/or drugs. However, improvements in communication between doctors and patients may promote better adherence in patients with SLE.