Measured versus self-reported compliance with doxycycline therapy for chlamydia-associated syndromes - High therapeutic success rates despite poor compliance
Measured versus self-reported compliance with doxycycline therapy for chlamydia-associated syndromes - High therapeutic success rates despite poor compliance
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DOI：
10.1097/00007435-199905000-00006
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发表时间：
1999-05-01
影响因子：
3.1
通讯作者：
Hook, EW
中科院分区：
文献类型：
--
作者：
Bachmann, LH;Stephens, J;Hook, EW
目的：比较在有沙眼衣原体治疗指征的性传播疾病门诊就诊的男性和女性自我报告的多西环素依从性与使用含有微计算机的药物瓶来计算每次打开药物瓶的时间和日期的依从性。第二个目的是将治疗结果（通过症状消退和衣原体核酸的持久性来测量）与多西环素依从性相关联。方法：1995年9月至1997年7月，采用药物事件监测系统（MEMS）帽对疑似沙眼衣原体感染的患者进行多西环素推荐治疗（7天14剂）的依从性评估。对随访评价时收集的尿液标本进行沙眼衣原体聚合酶链反应（PCR）检测。在221名可评估的参与者中，尽管90%的人报告按照指示服药，但根据MEMS上限获得的数据，只有33名（16%）患者达到了这一依从性水平。尽管144名（65%）患者在8天内服用了14种剂量中的11种以上，147名（67%）参与者在8天内两次剂量之间至少间隔24小时或更长时间。81名受试者入组时C沙眼培养呈阳性，随访尿PCR检测C沙眼；5例（6%）呈阳性。5例PCR检测阳性患者的用药事件监测系统数据显示，随访时，4例患者均有2个或2个以上的24小时间隔未打开药瓶，4例患者中有3例打开药瓶的次数少于11次。结论：本研究表明，很少有患者按处方服药，自我报告大大低估了服药不遵医嘱。尽管依从性差，但很少有治疗失败。
Objective: To compare self-reported doxycycline compliance in men and women attending an STD clinic with indications for Chlamydia trachomatis treatment to compliance measured using microprocessor- containing medication vials to count each time and date medication vials were opened, A secondary objective was to correlate outcomes of therapy, as measured by symptom resolution and persistence of chlamydial nucleic acids, with measured doxycycline compliance.Methods: Between September 1995 and July 1997, Medication Event Monitoring System (MEMS) caps were used to measure compliance with recommended doxycycline therapy (14 doses over 7 days) in patients treated for presumed C. trachomatis infections. Polymerase chain reaction (PCR) assays for C. trachomatis were performed on urine specimens collected at the time of follow-up evaluation,Results: Of 221 evaluable participants, although 90% reported taking their medication as directed, only 33 (16%) managed this level of compliance according to data obtained from the MEMS cap. Although 144 (65%) patients took more than 11 of 14 doses over 8 days, 147 (67%) participants had at least one interval of 24 hours or longer between doses in an 8-day period. Of 81 participants with positive C, trachomatis cultures at enrollment, follow-up urine PCR for C, trachomatis; was positive in 5 (6%), Medication Event Monitoring System data for four of the five patients with positive PCR tests as follow-up showed each had two or more 24-hour intervals when their medication vials were not opened and three of four had opened their vials less than 11 times.Conclusions: This study suggests that few patients take medications as prescribed and that self-report substantially underestimates medication noncompliance. Despite poor compliance, there were few treatment failures.