Medication Adherence in Gout: A Systematic Review
Medication Adherence in Gout: A Systematic Review
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DOI：
10.1002/acr.22336
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发表时间：
2014-10-01
影响因子：
4.7
通讯作者：
Bhole, Vidula
中科院分区：
文献类型：
--
作者：
De Vera, Mary A.;Marcotte, Greg;Bhole, Vidula
客观的。最近的数据表明痛风患者用药不依从的问题日益严重，因此需要综合该问题的负担、决定因素和影响。我们的目的是对现实环境中痛风患者用药依从性的文献进行系统回顾。方法。我们对 Medline、Embase、International Pharmaceutical Abstracts、PsycINFO 和 CINAHL 数据库进行了检索，并选择了现实环境中痛风患者和药物依从性的研究。我们提取了有关研究设计、样本量、随访时间、数据源（例如处方记录与电子监测与自我报告）、评估的不依从性问题类型、依从性测量和报告的估计以及多变量分析中报告的依从性的决定因素的信息。结果。我们纳入了 16 项研究，根据用于衡量依从性的方法进行分类，包括电子处方记录 (n = 10)、临床记录 (n = 1)、电子监控设备 (n = 1) 和自我报告 (n = 4)。所有研究均报告了不依从的负担，在基于电子处方记录的研究中，依从率均低于 0.80，依从患者比例为 10-46%。六项研究报告了决定因素，年龄较大和患有高血压并存与更好的依从性呈正相关。一项研究显示了坚持对实现血清尿酸目标的影响。结论。由于现实世界中只有不到一半的痛风患者坚持治疗，这项系统评价强调了医疗保健专业人员在与患者接触时讨论坚持用药的重要性。
Objective. Recent data suggesting the growing problem of medication nonadherence in gout have called for the need to synthesize the burden, determinants, and impacts of the problem. Our objective was to conduct a systematic review of the literature examining medication adherence among patients with gout in real-world settings.Methods. We conducted a search of Medline, Embase, International Pharmaceutical Abstracts, PsycINFO, and CINAHL databases and selected studies of gout patients and medication adherence in real-world settings. We extracted information on study design, sample size, length of followup, data source (e.g., prescription records versus electronic monitoring versus self-report), type of nonadherence problem evaluated, adherence measures and reported estimates, and determinants of adherence reported in multivariable analyses.Results. We included 16 studies that we categorized according to methods used to measure adherence, including electronic prescription records (n = 10), clinical records (n = 1), electronic monitoring devices (n = 1), and self-report (n = 4). The burden of nonadherence was reported in all studies, and among studies based on electronic prescription records, adherence rates were all below 0.80 and the proportion of adherent patients ranged from 10-46%. Six studies reported on determinants, with older age and having comorbid hypertension consistently shown to be positively associated with better adherence. One study showed the impact of adherence on achieving a serum uric acid target.Conclusion. With less than half of gout patients in real-world settings adherent to their treatment, this systematic review highlights the importance of health care professionals discussing adherence to medications during encounters with patients.