Adherence intervention research: What have we learned and what do we do next?
Adherence intervention research: What have we learned and what do we do next?
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DOI：
10.1067/mai.2003.1680
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发表时间：
2003-09-01
影响因子：
14.2
通讯作者：
Apter, A
中科院分区：
文献类型：
--
作者：
Bender, B;Milgrom, H;Apter, A
尽管研究普遍认为，坚持吸入皮质类固醇治疗往往不足以建立一致的控制，但在纠正问题的干预措施报告中，一致意见相对较少。一半的研究发现，实验干预并没有改变依从性，患者报告的行为变化通常不会伴随治疗成功的变化。研究使用了各种质量不同的方法，结果往往相互矛盾。许多研究的主要局限性包括依赖不充分的依从性措施、纳入积极性良好的患者的方便样本，以及因依从性最低的参与者的流失而人为地提高干预结果的评估。鼓励研究简短、易于实施、并且可以针对个体患者和不同临床环境进行定制的创新干预措施。特别重要的是要纳入难以接触到的患者，包括城市和农村的贫困患者，并定期采取有效的坚持措施，以建立持久的效益。
Although there is general agreement from studies demonstrating that adherence to inhaled corticosteroid therapy is often inadequate to establish consistent control, relatively little concurrence exists in reports of interventions to correct the problem. Half of the studies reviewed found that the experimental intervention did not change adherence, and behavior change reported by patients was often not accompanied by changes in treatment success. Studies used a variety of methods that differed in quality with findings that were often contradictory. Key limitations in many studies included reliance on inadequate adherence measures, inclusion of convenience samples of well-motivated patients, and assessments of intervention outcomes artificially boosted by attrition of least adherent participants. Research is encouraged into innovative interventions that are brief, easily implemented, and can be tailored to individual patients and diverse clinical settings. Of particular importance is inclusion of hard-to-reach patients, including urban and rural poor and the use of valid measures of adherence at intervals sufficient to establish enduring benefit.