Assessing theoretical predictors of long-term medication adherence: Patients' treatment-related beliefs, experiential feedback and habit development
Assessing theoretical predictors of long-term medication adherence: Patients' treatment-related beliefs, experiential feedback and habit development
复制标题
DOI：
10.1080/08870446.2013.793798
复制
发表时间：
2013-10-01
影响因子：
3.3
通讯作者：
Leventhal, Elaine A.
中科院分区：
文献类型：
--
作者：
Phillips, L. Alison;Leventhal, Howard;Leventhal, Elaine A.
患者不遵守药物治疗是一个普遍存在的问题，导致患者健康状况不佳和医疗保健费用高。迄今为止，基础研究和干预措施的重点是行为引发因素，例如患者的疾病和治疗信念。本文提出了行为开始后发生的两个过程，这两个过程理论上有助于预测长期药物依从性：患者从治疗经验和习惯发展中得出的信念的一致性。在基线访谈中，71例高血压患者报告了他们与治疗相关的信念、与治疗效果相关的经历和服药习惯的强度。然后患者使用电子监测药瓶大约一个月。患者的用药习惯强度是所有依从性测量中最强的预测因子，解释了患者治疗相关信念解释的依从性的6-27%的增量方差。患者的信念和经历并不能预测总体的依从性，即使对于那些习惯较弱的患者也是如此。然而，发现患者的经历可以预测有意的不遵守，而习惯强度可以预测无意的遵守。从业人员可能会评估病人的服药习惯，以初步了解他们是否可能坚持长期服药。未来的研究应在高血压初始样本和有症状人群中评估目前的理论预测。
Patient non-adherence to medication is a pervasive problem that contributes to poor patient health and high healthcare costs. Basic research and interventions have focused thus far on behaviour initiation factors, such as patients' illness and treatment beliefs. This paper proposes two processes that occur after behaviour initiation that are theorised to contribute to prediction of long-term medication adherence: coherence' of patients' beliefs from experiences with treatment and habit development. Seventy-one hypertensive patients reported their treatment-related beliefs, experiences related to treatment efficacy and medication-taking habit strength in a baseline interview. Patients then used an electronic monitoring pill bottle for approximately one month. Patients' medication habit-strength was the strongest predictor of all adherence measures, explaining 6-27% incremental variance in adherence to that explained by patients' treatment-related beliefs. Patients' beliefs and experiences did not predict overall adherence, even for patients with weaker' habits. However, patients' experiences were found to predict intentional non-adherence and habit strength was found to predict unintentional adherence. Practitioners may assess patients' medication-taking habits to get an initial view of their likely adherence to long-term medications. Future research should assess the current theoretical predictions in a hypertension inception sample and in populations with symptomatic conditions.