Can one or two simple questions predict poor medication adherence?
Can one or two simple questions predict poor medication adherence?
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一两个简单的问题可以预测药物依从性差吗？
DOI：
10.1111/jep.13389
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发表时间：
2021
影响因子：
2.4
通讯作者：
Xu,Jing
中科院分区：
文献类型：
--
作者：
Stuart,BruceC;Timmons,Veronica;Loh,Feng-HuaE;Dai,Mingliang;Xu,Jing
依据、目的和目标循证药物依从性差是传统临床实践中的一个主要问题。需要更好的预后工具来识别那些最有可能不依从的患者。本研究的目的是，以确定如果2-item患者激活状态（PAS）措施确定医疗保险受益人的风险，坚持不良的药物通常建议在治疗2型diabetes.MethodsPAS和药物依从性进行了评估的受访者2009年医疗保险当前受益人调查，然后使用双变量和多变量检验进行比较。参与者的PAS被分为“积极”，“高度努力”，“自满”或“被动”，这取决于他们对确定所需医疗护理的信心以及他们是否带着药物清单去看医生。使用覆盖天数比例（PDC）评估口服抗糖尿病药物、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和他汀类药物的依从性。结果2009年共有940名患有糖尿病的医疗保险受益人参加了D部分计划。PAS对药物依从性的总体影响较小（自满/被动与主动/高努力受益者的PDC降低3%，P< 0.10）。然而，自满/被动PAS与其他与依从性差相关的特征的相互作用确定了某些亚组特别容易出现依从性问题：年龄< 65岁（PDC − 11%，P < 0.05），非西班牙裔黑人（PDC − 13%，P < 0.05），病态肥胖（-9%，P < 0.10）.结论一个关于带药单去看医生的单一问题可能有助于识别在常规实践中依从性差的患者亚组，但需要更大的样本来验证和扩展这些发现。
Rationale, Aims, and ObjectivesPoor adherence to evidence‐based medications is a major problem in conventional clinical practise. Better prognostic tools are needed to identify those with the highest likelihood of being non‐adherent. The objective of this study is to determine if a 2‐item patient activation status (PAS) measure identifies Medicare beneficiaries at risk of poor adherence to drugs typically recommended in treating type 2 diabetes.MethodsPAS and medication adherence were assessed for respondents to the 2009 Medicare Current Beneficiary Survey and then compared using bivariate and multivariate tests. Participants' PAS was classified as “active,” “high effort,” “complacent,” or “passive” based on how confident they were in identifying needed medical care and whether they brought medication lists to their doctors' visits. Adherence with oral antidiabetic drugs, angiotensin‐converting enzyme‐inhibitors/angiotensin receptor blockers, and statins was assessed using proportion of days covered (PDC).ResultsA total of 940 Medicare beneficiaries with diabetes enrolled in Part D plans in 2009. The overall effect of PAS on medication adherence was small (3% lower PDC for complacent/passive vs active/high effort beneficiaries,P< 0.10). However, interactions of complacent/passive PAS with other characteristics associated with poor adherence identified certain subgroups as especially prone to problematic adherence: age < 65 (PDC −11%,P< 0.05), non‐Hispanic black (PDC −13%,P< 0.05), and morbidly obese (−9%,P< 0.10).ConclusionA single question relating to taking medication lists to doctor visits may help identify patient subgroups prone to poor adherence in conventional practise, but larger samples are necessary to validate and extend these findings.
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影响因子：
3
作者：
Heller, Amy;Elliott, Marc N.;Kanouse, David E.
通讯作者：
Kanouse, David E.
影响因子：
3
作者：
Lorig, KR;Sobel, DS;Holman, HR
通讯作者：
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DOI：
10.1108/17506120710818210
发表时间：
2007
影响因子：
1.2
作者：
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通讯作者：
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影响因子：
9.7
作者：
Hibbard, Judith H.;Greene, Jessica;Overton, Valerie
通讯作者：
Overton, Valerie
影响因子：
1.4
作者：
Lubetkin, Erica I.;Lu, Wei-Hsin;Gold, Marthe R.
通讯作者：
Gold, Marthe R.