A reliable method for evaluating drug compliance in children with cancer
A reliable method for evaluating drug compliance in children with cancer
复制标题
评估癌症儿童药物依从性的可靠方法
作者：
Stephen D. Smith;D. Rosen;R. Trueworthy;J. Lowman
不良的药物依从性可能会导致恶性肿瘤儿童的生存率下降。没有服药的儿童没有接受最佳剂量的化疗，次优治疗会缩短癌症儿童的生存期。这是对52名癌症儿童在三个不同治疗阶段的泼尼松依从性的研究。已知患者正在服用泼尼松（治疗组）、停用泼尼松（治疗组）或其依从性未知（未知组）。通过测量血红蛋白水平变化、体重变化和随机尿17-生酮类固醇来评估泼尼松依从性。获得的结果表明，虽然血红蛋白和体重变化没有帮助，但随机尿17-生酮类固醇测定能够清楚地区分正在服用泼尼松的患者。通过使用该分析，发现33%的患者根据方案和说明应该接受泼尼松治疗，但没有依从。对青少年的单独分析显示，更令人震惊的是，59%的不遵守率。这种惊人的不依从性强烈表明，患者的生存可能受到不依从性的威胁。
Poor drug compliance may cause a decreased survival of children with malignancies. Children who fail to take their medications are not receiving optimum amounts of chemotherapy and suboptimal therapy causes a shortened survival in children with cancer. This is a study of prednisone compliance in 52 children with cancer during three distinct phases of therapy. The patients were either known to be taking prednisone (on‐therapy group), off prednisone (off‐therapy group), or their compliance was unknown (unknown group). Evaluation of prednisone compliance was attempted by measuring hemoglobin level changes, weight changes, and random urinary 17‐ketogenic steroids. The results obtained show that while hemoglobin and weight changes are not helpful, a random urine 17‐ketogenic steroid assay is able to differentiate clearly those patients who are taking their prednisone. By the use of this assay it was found that 33% of patients who by protocol and instruction were supposed to be receiving prednisone were not complying. Separate analysis of adolescents revealed an even more alarming 59% noncompliance rate. This striking level of noncompliance strongly suggests that the survival of patients may be threatened by noncompliance.