Medication adherence: A challenge for patients with postmenopausal osteoporosis and other chronic illnesses
Medication adherence: A challenge for patients with postmenopausal osteoporosis and other chronic illnesses
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DOI：
10.18553/jmcp.2006.12.s6-a.s20
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发表时间：
2006-07-01
影响因子：
--
通讯作者：
Gold, Deborah T.
中科院分区：
文献类型：
--
作者：
Gold, Deborah T.
目的：定义药物依从性，并描述各种评估方法的局限性，不依从用于管理慢性疾病的药物治疗的原因，不依从骨质疏松症药物治疗的影响，以及改善药物治疗依从性的策略。背景：药物治疗不依从性是一个重大的公共卫生问题，对患者的预后产生不利影响，并增加医疗保健的利用率和成本。绝经后骨质疏松症是一种慢性疾病，坚持药物治疗用于管理疾病是一个挑战，因为它是在其他慢性diseases.SUMMARY：服药依从性反映了依从性和持久性。直接评估方法（例如，观察，实验室血清药物测定）比间接方法更准确，但它们更昂贵，而且往往不切实际。间接方法包括患者自我报告和使用处方续药记录、药丸计数和电子监测设备。绝经后骨质疏松症或其他慢性疾病患者的药物依从性不佳。不良反应、财务限制、与处方医生的错误沟通以及认为药物是不必要的都是药物不依从的可能原因。无意的不遵守是一个被动的过程，往往只是忘记，故意不遵守是一个主动的过程，涉及一个深思熟虑的选择，往往是基于不利影响或感知缺乏benefit.CONCLUSIONS：不遵守骨质疏松症药物治疗会对患者的预后产生不利影响，并增加医疗保健的利用率和成本。需要一种基于患者偏好和改变意愿的个性化方法来提高药物依从性。
OBJECTIVE: To define medication adherence and describe the limitations of various assessment methods, reasons for nonadherence to medications used to manage chronic illness, the impact of nonadherence to osteoporosis medications, and strategies for improving medication adherence.BACKGROUND: Medication nonadherence is a major public health problem that adversely affects patient outcomes and increases health care utilization and costs. Postmenopausal osteoporosis is a chronic disease, and adherence to drug therapy used to manage the disease is as much of a challenge as it is in other chronic diseases.SUMMARY: Medication adherence reflects both compliance and persistence. Direct assessment methods (e.g., observation, laboratory serum drug assays) are more accurate than indirect methods, but they are more costly and often impractical. Indirect methods include patient self-report and the use of prescription refill records, pill counts, and electronic monitoring devices. Medication adherence in patients with postmenopausal osteoporosis or other chronic illnesses is less than optimal. Adverse effects, financial constraints, miscommunication with the prescriber, and a perception that medications are unnecessary are among the possible reasons for medication nonadherence. Unintentional nonadherence is a passive process, often simply forgetting, and intentional nonadherence is an active process involving a deliberate choice, often based on adverse effects or a perceived lack of benefit.CONCLUSIONS: Nonadherence to osteoporosis medications can adversely affect patient outcomes and increase health care utilization and costs. An individualized approach to improving medication adherence based on patient preferences and readiness to change is needed.