A Comprehensive Perspective on Patient Adherence to Topical Glaucoma Therapy
A Comprehensive Perspective on Patient Adherence to Topical Glaucoma Therapy
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DOI：
10.1016/j.ophtha.2009.06.024
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发表时间：
2009-11-01
期刊：
影响因子：
13.7
通讯作者：
Tsai, James C.
中科院分区：
文献类型：
--
作者：
Tsai, James C.
题目：局部青光眼药物治疗方案依从性差或不依从性差的危险因素。Clinical Relevance：青光眼药物治疗方案依从性差可能与随后的视力丧失和不可逆的视神经损伤有关。Methods：使用“glaucoma AND adherence AND risk”和“glaucoma AND compliance AND risk”进行文献检索，仅限于英文研究，并关注美国的护理。在这一领域备受推崇的期刊的出版物进行了审查，并提出了一个集中的文献摘要presented.Results：有无数的坚持固有的青光眼患者人群的障碍。虽然这些障碍中的大多数在老年人中很常见（例如，认知能力下降、肌肉骨骼问题和交通困难），年龄较大尚未被证明是青光眼药物治疗方案依从性差的一致风险因素。其他预期障碍，如药物费用、有限的健康保险、疾病严重程度和复杂给药方案的作用，根据研究的患者人群和依从性定义，具有不同的影响。药物依从性差也与对随访医疗访视时间表的依从性降低有关。粘附障碍的系统分类已经制定。此外，从青光眼的依从性和持续性研究的子分析确定了8个变量，影响青光眼药物治疗方案的依从性，以及支持的重要性和医患communications.Conclusions之间的关联的几个特征：最近的研究提供了宝贵的见解到许多因素，增加了风险（S）为患者处方青光眼药物的依从性差。已经确定了有效患者依从性的四种主要障碍类型（药物治疗方案、患者因素、提供者因素和情境或环境因素）。解决这些具体的障碍将需要一个量身定制的，以病人为中心的方法。财务披露（S）：专有或商业披露后，可能会发现参考。Ophthalmology 2009; 116：S30-S36（C）2009由American Academy of Ophthalmology.
Topic: Risk factors for poor adherence or nonadherence to topical glaucoma medication regimens.Clinical Relevance: Poor adherence to glaucoma medication regimens maybe associated with subsequent visual loss and irreversible optic nerve damage.Methods: A literature search was performed using the words "glaucoma AND adherence AND risk" and "glaucoma AND compliance AND risk," limited to those studies in English and focused on care in the United States. Publications from well-regarded journals in this field were reviewed, and a focused summary of the literature is presented.Results: There are a myriad of adherence barriers inherent to the glaucoma patient population. Although most of these obstacles are common in the elderly (e.g., reduced cognition, musculoskeletal problems, and transportation difficulties), older age has not been shown to be a consistent risk factor for poor adherence to glaucoma medication regimens. Other expected barriers, such as medication cost, limited health insurance, disease severity, and role of complicated dosing regimens, have varied effects based on the patient population studied and the definition of adherence. Poor medication adherence also is associated with decreased adherence to follow-up medical visit schedules. A systematic taxonomy of adherence barriers has been formulated. In addition, subanalyses from the Glaucoma Adherence and Persistency Study identified 8 variables that affect adherence to glaucoma medication regimens as well as several characteristics that support the importance of and associations between doctor-patient communications.Conclusions: Recent studies have provided valuable insights into the many factors that increase the risk(s) for poor adherence in patients prescribed glaucoma medications. Four major types of barriers to effective patient adherence (medication regimen, patient factors, provider factors, and situational or environmental factors) have been identified. Addressing these specific barriers will require a tailored, patient-centered approach.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2009; 1 16:S30-S36 (C) 2009 by the American Academy of Ophthalmology.