Medication Adherence Among Patients With Corneal Diseases.
Medication Adherence Among Patients With Corneal Diseases.
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DOI：
10.1097/ico.0000000000002680
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发表时间：
2021-12-01
期刊：
影响因子：
2.8
通讯作者：
Woodward MA
中科院分区：
文献类型：
--
作者：
Khan M;Michelson S;Newman-Casey PA;Woodward MA
药物不依从性是一个普遍存在的问题。然而，患者对药物治疗角膜疾病的依从性尚不清楚。一项前瞻性队列研究调查了角膜疾病患者的滴眼液依从性模式。从学术中心的角膜诊所招募了≥ 18岁的处方眼科药物患者。收集的数据包括年龄、性别、眼部药物总剂量和主要角膜诊断类别。参与者完成了12个问题的再填充和药物依从性量表（ARMS）和3个问题的药物依从性量表（VMAS）的改编版本。调查数据分为"依从性"和"非依从性"，并报告了非依从性原因的分量表。Logistic回归分析用于检验与依从性的关联。2019年2月至3月，共有199名参与者接受了调查（回复率为95%）。参与者年龄在19至93岁之间，平均年龄为59岁（SD 17.8）。参与者被认为是不遵守的百分比是72%的ARMS和33%的VMAS。年龄越大，ARMS（比值比（OR）= 1.48，95%置信区间（CI）：1.14 - 1.93，p = 0.004）和VMAS（OR = 1.24，CI：1.04 - 1.48，p = 0.012）的依从性越高。依从性与种族、性别、教育、眼部药物总剂量或主要角膜诊断无显著相关。药物依从性低于预期，特别是在ARMS量表上，要求更详细的问题。临床医生应该参与关于依从性的对话，特别是与年轻患者，如果他们没有看到预期的临床反应。
Medication non-adherence is a ubiquitous problem. However, the adherence of patients to medications to manage corneal conditions is unknown. A prospective cohort study investigated the patterns of eye drop adherence among patients with corneal conditions. Patients ≥18 years taking prescription eye medications were recruited from an academic-center’s cornea clinic. Data collected included age, gender, total doses of eye medications, and category of primary corneal diagnosis. Participants completed adapted versions of the 12 question Adherence to Refills and Medications Scale (ARMS) and the three question Voils Medication Adherence Scale (VMAS). Survey data was dichotomized as “adherent” and “non-adherent” and subscales reported for reasons of non-adherence. Logistic regression analyses were used to test associations with adherence. A total of 199 participants were surveyed February to March 2019 (95% response rate). Participants were aged 19 to 93 with a mean age of 59 (SD 17.8). The percent of participants were considered non-adherent was 72% by ARMS and 33% by VMAS. Older age was associated with higher adherence by ARMS (odds ratio (OR)=1.48, 95% confidence interval (CI): 1.14–1.93, p=0.004) and by VMAS (OR=1.24, CI: 1.04–1.48, p=0.012). Adherence was not significantly associated with race, gender, education, total doses of eye medications, or primary cornea diagnosis. Medication adherence was lower than expected, particularly on the ARMS scale that asks more detailed questions. Clinicians should engage in conversations about adherence, especially with younger patients, if they are not seeing an expected clinical response.