'What the herbal medicine can do for me in a week, the orthodox does in a year': Perceived efficacy of local alternative therapies influences medication adherence in patients with atherosclerotic cardiovascular disease.
'What the herbal medicine can do for me in a week, the orthodox does in a year': Perceived efficacy of local alternative therapies influences medication adherence in patients with atherosclerotic cardiovascular disease.
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DOI：
10.1111/hex.13185
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Perel P
中科院分区：
文献类型：
--
作者：
Laar A;Amoah Ampah E;Fernandez Y;Senyo Amevinya G;Nortey P;Benyah F;Akamah J;Ambenne M;Lamptey P;Free C;Legido-Quigley H;Perel P
有强有力的证据表明，抗血小板治疗、ACE抑制剂、β受体阻滞剂和他汀类药物在减少动脉粥样硬化性心血管疾病（ACVD）患者的后续心血管疾病（CVD）事件方面具有成本效益。在某些情况下，只有很低比例的人能够获得这些药物，甚至更低的人坚持使用这些药物。目前的研究探讨并提供了关于确诊动脉粥样硬化性心血管疾病（ACVD）患者对传统药物依从性差的原因和替代疗法的动机的数据。该研究是在加纳首都阿克拉患有ACVD的城市居民成年人中进行的。对确诊的ACVD患者进行了18次访谈。与其中一些人进行了后续焦点小组讨论。该方案得到了加纳和联合王国两个伦理审查委员会的批准。所有参与者在知情同意后接受采访。使用Nvivo定性数据分析软件进行分析。我们确定了使用替代传统疗法的动机。这些涵盖了依从性的五个维度：社会和经济、医疗保健系统、疾病相关、治疗相关和患者相关维度。认为传统药物无法提供即时益处是使用替代形式药物的重要动机。多种因素促使患者不依从传统疗法。有效性和容易获得当地替代疗法，如草药和基于信仰的疗法是重要的动力。
There is strong evidence that anti‐platelet therapy, ACE inhibitors, beta‐blockers and statins are cost‐effective in reducing subsequent cardiovascular disease (CVD) events in patients with atherosclerotic cardiovascular disease (ACVD). In some settings, only a low proportion of people have access to these medications, and even lower adhere to them. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD). The study was conducted among city‐dwelling adults with ACVD in Accra – Ghana's capital city. Eighteen interviews were conducted with patients with established ACVD. A follow‐up focus group discussion was conducted with some of them. The protocol was approved by two ethics review committees based in Ghana and in the United Kingdom. All participants were interviewed after informed consent. Analysis was done with the Nvivo qualitative data analysis software. We identified motivations for use of alternatives to orthodox therapies. These cover the five dimensions of adherence: social and economic, health‐care system, condition‐related, therapy‐related, and patient‐related dimensions. Perceived inability of an orthodox medication to provide immediate benefit is an important motivator for use of alternative forms of medication. A multiplicity of factors precipitate non‐adherence to orthodox therapies. Perceived efficacy and easy access to local alternative therapies such as herbal and faith‐based therapies are important motivators.
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