Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors.
Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors.
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DOI：
10.2147/ppa.s106821
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发表时间：
2016
影响因子：
2.2
通讯作者：
Henry RR
中科院分区：
文献类型：
--
作者：
Polonsky WH;Henry RR
至少有45%的2型糖尿病（T2 D）患者未能实现充分的血糖控制（HbA 1c <7%）。其中一个主要因素是药物依从性差。有充分证据表明，T2 D患者的药物依从性差非常常见，并与血糖控制不足、发病率和死亡率增加以及门诊护理、急诊室就诊、住院和糖尿病并发症管理成本增加相关。药物依从性差与关键的非患者因素有关（例如，许多医疗保健系统缺乏综合护理，医疗保健专业人员缺乏临床惰性），患者人口统计学因素（例如，年轻、教育水平低和收入水平低）、患者对其药物的关键信念（例如，感知到的治疗无效）和感知到的患者获取和服用药物的负担（例如，治疗复杂性、自付费用和低血糖）。T2 D患者药物依从性的具体障碍，特别是那些可能改变的障碍，需要更清楚地确定;针对依从性差的策略应侧重于减少药物负担和解决患者的负面药物信念。解决这些问题需要行为创新以及新的药物输送方法和模式。
At least 45% of patients with type 2 diabetes (T2D) fail to achieve adequate glycemic control (HbA1c <7%). One of the major contributing factors is poor medication adherence. Poor medication adherence in T2D is well documented to be very common and is associated with inadequate glycemic control; increased morbidity and mortality; and increased costs of outpatient care, emergency room visits, hospitalization, and managing complications of diabetes. Poor medication adherence is linked to key nonpatient factors (eg, lack of integrated care in many health care systems and clinical inertia among health care professionals), patient demographic factors (eg, young age, low education level, and low income level), critical patient beliefs about their medications (eg, perceived treatment inefficacy), and perceived patient burden regarding obtaining and taking their medications (eg, treatment complexity, out-of-pocket costs, and hypoglycemia). Specific barriers to medication adherence in T2D, especially those that are potentially modifiable, need to be more clearly identified; strategies that target poor adherence should focus on reducing medication burden and addressing negative medication beliefs of patients. Solutions to these problems would require behavioral innovations as well as new methods and modes of drug delivery.