Frequency of and reasons for medication non-fulfillment and non-persistence among American adults with chronic disease in 2008
Frequency of and reasons for medication non-fulfillment and non-persistence among American adults with chronic disease in 2008
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DOI：
10.1111/j.1369-7625.2010.00619.x
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发表时间：
2011-09-01
影响因子：
3.2
通讯作者：
Spain, Charles V.
中科院分区：
文献类型：
--
作者：
McHorney, Colleen A.;Spain, Charles V.
目的 找出患有慢性病的成年人不按新处方（未服药）和/或在没有医生指示的情况下停止服药（缺乏药物坚持）的自我报告原因。 方法 参与者于 2008 年从全国性、基于互联网的美国慢性病成年人小组中抽取。共有 19 830 名受访者回答了有关不履行和不坚持用药以及不履行和不坚持用药的原因的问题。在自我认定为不满足者和不坚持者的人中，统计分析评估了报告的不满足者和不坚持的原因与慢性病之间的关联。受访者的子样本完成了另一项调查，其中包括评估大多数不满足和不持久原因的匹配结构的多项目量表。根据多项目量表评估自我报告原因的收敛效度。 结果 对于不履行药物治疗和不坚持药物治疗最常报告的四个原因相同：支付药物费用、经济困难（分别为 56% 和 43%）；害怕或经历副作用（分别为 46% 和 35%）；对药物的普遍担忧（分别为 32% 和 23%）；缺乏对药物的需求（分别为 25% 和 23%）。报告原因的频率因慢性疾病而有所不同。大多数自我报告原因的收敛效度都通过测量匹配结构的多项目量表得到了证实。 结论 在美国慢性病成人的大型互联网样本中观察到了药物不履行和不依从的相同主要原因。未来提高药物依从性的努力应该解决患者的用药问题、对药物的感知需求以及药物负担能力。
Objective To identify self-reported reasons why adults with chronic disease do not fill a new prescription (medication non-fulfillment) and/or stop taking a medication without their physician telling them to do so (lack of medication persistence).Methods Participants were sampled in 2008 from a national, internet-based panel of American adults with chronic disease. A total of 19 830 respondents answered questions about medication non-fulfillment and medication non-persistence and reasons for non-fulfillment and non-persistence. Among persons self-identified as non-fulfillers and non-persisters, statistical analyses assessed the association between reported reasons for non-fulfillment and non-persistence and chronic disease. A subsample of respondents completed an additional survey which included multi-item scales assessing matched constructs of most of the reasons for non-fulfillment and non-persistence. The convergent validity of the self-reported reasons was assessed against the multi-item scales.Results The same four reasons were most commonly reported for both medication non-fulfillment and medication non-persistence: paying for the medication a financial hardship (56 and 43%, respectively); fear or experience of side effects (46 and 35%, respectively); generic concerns about medications (32 and 23%, respectively); and lack of perceived need for the medication (25 and 23%, respectively). The frequency with which the reasons were reported varied somewhat by chronic disease. The convergent validity of most of the self-reported reasons was confirmed against multi-item scales measuring matched constructs.Conclusions The same top reasons for medication non-fulfillment and non-adherence were observed in a large internet-based sample of American adults with chronic disease. Future efforts to improve medication adherence should address patients' medication concerns, perceived need for medications, and perceived medication affordability.