Adherence to treatment in men with hypogonadotrophic hypogonadism
Adherence to treatment in men with hypogonadotrophic hypogonadism
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DOI：
10.1111/cen.13236
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发表时间：
2017-03-01
影响因子：
3.2
通讯作者：
Morin, Diane
中科院分区：
文献类型：
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作者：
Dwyer, Andrew A.;Tiemensma, Jitske;Morin, Diane
患有先天性低促性腺激素性腺功能减退症（CHH）的男性通常需要终身激素治疗，停止治疗可能会对健康产生负面影响。关于坚持治疗或CHH的心理社会影响知之甚少。DesignA序贯，多方法的方法被使用。一项定量在线调查评估了对治疗的依从性、抑郁症状和疾病感知。随后，定性焦点小组探讨了患者报告的因素，为adherence.PatientsAdult男性CHH至少1年的治疗招募international.MeasurementsAdherence（Morisky药物依从性量表），抑郁症状（Zung抑郁自评量表）和患者的CHH（修订的疾病感知问卷）的感知进行了评估，在一个在线调查，并进行了比较，以参考组。患者焦点小组进行了讨论和主题分析，以确定患者报告的因素adherence.ResultsIn总，101名男子长期治疗（平均年龄37 - 11岁）。43%（43/101）的患者表现出较低的药物依从性，轻度、中度和重度抑郁症状的患病率显著升高（分别为27%、17%、20%，均P <0.001）。患者报告的负面疾病的看法和显着的心理社会后果。焦点小组讨论（n = 3，共26例）确定患者，卫生专业人员和医疗保健系统相关的障碍为目标，以提高administration.ConclusionsCongenital hypogonadotrophic hypogonadism男性的挑战，坚持长期治疗。依从性差可能会对骨骼、性和心理健康产生不良影响。CHH的心理社会发病率是显着的，似乎是低估了医疗保健提供者。
ObjectiveMen with congenital hypogonadotrophic hypogonadism (CHH) typically require lifelong hormonal therapy, and discontinuing treatment can have negative health consequences. Little is known about adherence to treatment or the psychosocial impact of CHH.DesignA sequential, multiple methods approach was used. A quantitative online survey assessed adherence to treatment, depressive symptoms and illness perceptions. Subsequently, qualitative focus groups explored patient-reported factors for adherence.PatientsAdult men with CHH on at least 1 year of treatment were recruited internationally.MeasurementsAdherence (Morisky medication adherence scale), depressive symptoms (Zung self-rating depression scale) and patient perception of CHH (revised illness perception questionnaire) were assessed in an online survey, and comparisons were made to reference groups. Patient focus group discussions were conducted and thematic analysis was employed to identify patient-reported factors for adherence.ResultsIn total, 101 men on long-term treatment were included (mean age 37 11 years). Forty three percent (43/101) exhibited low medication adherence and a significantly elevated prevalence of mild, moderate or severe depressive symptoms (27%, 17%, 20%, respectively, all P < 0001 vs reference population). Patients reported negative illness perceptions and significant psychosocial consequences. Focus group discussions (n = 3, 26 total patients) identified patient-, health professional- and healthcare system-related barriers as targets for improving adherence.ConclusionsCongenital hypogonadotrophic hypogonadism men are challenged to adhere to long-term treatment. Poor adherence may contribute to adverse effects on bone, sexual and psychological health. The psychosocial morbidity of CHH is significant and appears to be underappreciated by healthcare providers.