Ophthalmologist-patient communication, self-efficacy, and glaucoma medication adherence.
Ophthalmologist-patient communication, self-efficacy, and glaucoma medication adherence.
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DOI：
10.1016/j.ophtha.2014.11.001
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发表时间：
2015-04
期刊：
影响因子：
13.7
通讯作者：
Robin AL
中科院分区：
文献类型：
--
作者：
Sleath B;Blalock SJ;Carpenter DM;Sayner R;Muir KW;Slota C;Lawrence SD;Giangiacomo AL;Hartnett ME;Tudor G;Goldsmith JA;Robin AL
该研究的目的是检查医患沟通、青光眼药物依从性自我效能、结果预期和青光眼药物依从性之间的关联。前瞻性观察队列研究。在六个眼科诊所招募了 279 名新开处方或正在服用青光眼药物的青光眼患者。患者的就诊过程被录像，交流变量则使用作者开发的详细编码工具进行编码。在就诊后 60 天内，使用用药事件监测系统测量依从性。在就诊后的 60 天期间测量以下依从性变量：患者是否服用了 80% 或更多的处方剂量、每天服用处方剂量的正确数量百分比以及按时服用处方剂量的百分比。较高的青光眼药物依从性自我效能与对所有三项措施的更好依从性呈正相关。非裔美国人种族与每天服用的正确剂量百分比（β= -0.16，p<0.05）以及患者是否服用了 80% 或更多处方剂量（比值比 = 0.37，95% 置信区间 0.16，0.86）呈负相关。关于如何使用滴剂的医生教育与每天正确服用剂量的百分比（β = 0.18，p <0.01）和按时服用处方剂量的百分比（β = 0.15，p <0.05）呈正相关。这些发现表明，提供者对如何使用青光眼滴剂和患者青光眼药物依从性自我效能的教育与依从性呈正相关。
The objective of the study was to examine the association between provider-patient communication, glaucoma medication adherence self-efficacy, outcome expectations, and glaucoma medication adherence. Prospective observational cohort study. 279 patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients’ visits were video-tape recorded and communication variables were coded using a detailed coding tool developed by the authors. Adherence was measured using Medication Event Monitoring Systems for 60 days after their visits. The following adherence variables were measured for the 60 day period after their visits: whether the patient took 80% or more of the prescribed doses, percent correct number of prescribed doses taken each day, and percent prescribed doses taken on time. Higher glaucoma medication adherence self-efficacy was positively associated with better adherence with all three measures. African American race was negatively associated with percent correct number of doses taken each day (beta= −0.16, p<0.05) and whether the patient took 80% or more of the prescribed doses (odds ratio=0.37, 95% confidence interval 0.16, 0.86). Physician education about how to administer drops was positively associated with percent correct number of doses taken each day (beta= 0.18, p<0.01) and percent prescribed doses taken on time (beta=0.15, p<0.05). These findings indicate that provider education about how to administer glaucoma drops and patient glaucoma medication adherence self-efficacy are positively associated with adherence.