Physicians' Ability to Predict Patients' Adherence to Antihypertensive Medication in Primary Care
Physicians' Ability to Predict Patients' Adherence to Antihypertensive Medication in Primary Care
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DOI：
10.1291/hypres.31.1765
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发表时间：
2008-09-01
影响因子：
5.4
通讯作者：
Tschudi, Peter
中科院分区：
文献类型：
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作者：
Zeller, Andreas;Taegtmeyer, Anne;Tschudi, Peter
解决药物依从性是必不可少的，也是众所周知的困难。本研究的目的是确定医生预测患者坚持抗高血压治疗的能力。要求初级保健医生在研究开始时使用视觉模拟量表（VAS）预测高血压患者（n=42）的药物依从性。要求患者使用VAS报告其药物依从性。然后通过使用医疗事件监测系统（MEMS）监测依从性42 +/-14天。时间依从性、正确给药和药物依从性的MEMS测量的平均值+/- SD（范围）分别为82 +/- 27%（0 - 100%）、87 +/- 24%（4 - 100%）和94 +/- 18%（4 - 108%）。医生对患者依从性的预测为92 ± 15%。医生的预测与MEMS测量的时间依从性、正确给药和药物依从性之间的斯皮尔曼等级相关性分别为0.42（p=0.006）、0.47（p=0.002）和-0.02（p=0.888）。患者报告自己的药物依从性为98 +/- 2%（范围83 - 100%）。报告的行为和实际行为之间的斯皮尔曼相关性对于时间依从性为0.27（p=0.08），对于正确给药为0.25（p=0.12），对于药物依从性为0.11（p=0.51）。医生预测患者对抗高血压药物的依从性的能力是有限的，并且在临床实践中识别不依从患者是不准确的。甚至患者自己也无法准确报告自己对药物的依从性。（Hypertens Res 2008; 31：1765-1771）
Addressing adherence to medication Is essential and notoriously difficult. The purpose of this study was to determine physicians' ability to predict patients' adherence to anti hypertensive therapy. Primary care physicians were asked to predict the adherence to medication of their hypertensive patients (n=42) by using a visual analogue scale (VAS) at the beginning of the study period. The patients were asked to report their adherence to medication using a VAS. The adherence was then monitored by using a Medical Event Monitoring System (MEMS) for 42 +/- 14 d. The means +/- SD (range) of MEMS measures for timing adherence, correct dosing, and adherence to medication were 82 +/- 27% (0 to 100%), 87 +/- 24% (4 to 100%), and 94 +/- 18% (4 to 108%), respectively. The physicians' prediction of their patients' adherence was 92 +/- 15%. The Spearman rank correlations between the physician's prediction and the MEMS measures of timing adherence, correct dosing, and adherence to medication was 0.42 (p=0.006), 0.47 (p=0.002), and -0.02 (p=0.888), respectively. The patients reported their own adherence to medication at 98 +/- 2% (range 83 to 100%). The Spearman correlations between the reported and actual behaviours were 0.27 (p=0.08) for timing adherence, 0.25 (p=0.12) for correct dosing, and 0.11 (p=0.51) for adherence to medication. The physicians' ability to predict patients' adherence to antihypertensive medication is limited and not accurate for Identifying non-adherent patients in clinical practice. Even patients themselves are unable to give accurate reports of their own adherence to medication. (Hypertens Res 2008; 31: 1765-1771)