A GENERAL-METHOD OF COMPLIANCE ASSESSMENT USING CENTRALIZED PHARMACY RECORDS - DESCRIPTION AND VALIDATION
A GENERAL-METHOD OF COMPLIANCE ASSESSMENT USING CENTRALIZED PHARMACY RECORDS - DESCRIPTION AND VALIDATION
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DOI：
10.1097/00005650-198808000-00007
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发表时间：
1988-08-01
期刊：
影响因子：
3
通讯作者：
INUI, TS
中科院分区：
文献类型：
--
作者：
STEINER, JF;KOEPSELL, TD;INUI, TS
集中药房的处方续药记录是有关患者长期用药依从性的潜在信息来源。我们开发了一种方法来评估在这种情况下的依从性，并验证了我们的措施，使用药房数据和癫痫发作和高血压患者的临床信息。对于服用抗惊厥药物苯妥英的患者，药物依从性与平均血浆苯妥英水平显著相关。对于服用抗高血压药物的患者，治疗方案的依从性与舒张压的控制相关。许多患者（苯妥英验证中为15%，血压验证中为33%）获得了大量的药物过量;对于这些患者，依从性和药物效应之间的直接关系并不明显。大多数癫痫发作患者的“亚治疗”平均血浆苯妥英水平被确定为不符合我们的措施。我们的结论是，我们的方法来评估在获得药物的依从性是可行的，在“管理式护理”的设置，似乎是一个有效的药物效应的相关性，并可能是有用的研究和病人护理。
The prescription refill records of centralized pharmacies are a potential source of information about patient compliance with long-term medications. We developed a method for assessing compliance in such settings and validated our measures using pharmacy data and clinical information from patients with seizure disorders and hypertension. For patients taking the anticonvulsant medication phenytoin, compliance with the drug correlated significantly with mean plasma phenytoin level. For patients on antihypertensive medications, compliance with the treatment regimen correlated with control of diastolic blood pressure. Many patients (15% in the phenytoin validation, and 33% in the blood pressure validation) obtained substantial oversupplies of medications; for these patients, the direct relationship between compliance and drug effect was not evident. A majority of seizure patients with "subtherapeutic" mean plasma phenytoin levels were identified as noncompliant using our measures. We conclude that our method of assessing compliance in obtaining medications is feasible in "managed care" settings, appears to be a valid correlate of drug effects, and may be useful in research and patient care.