Non-adherence to treatment: a methodological approach to compensating for its impact in chronic infections, using tuberculosis as a model disease.
不坚持治疗:一种以结核病为模型疾病来补偿其对慢性感染影响的方法。
基本信息
- 批准号:MR/R008345/1
- 负责人:
- 金额:$ 134.97万
- 依托单位:
- 依托单位国家:英国
- 项目类别:Fellowship
- 财政年份:2018
- 资助国家:英国
- 起止时间:2018 至 无数据
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Imperfectly designed treatment regimens for chronic (i.e. long-lasting) diseases result in continued, and possibly worsened, symptoms. When a disease can be passed from person-to-person we additionally risk the development and spread of drug resistance, which is when a bacterium or virus becomes untreatable by normal medicines as it has genetically changed. This endangers both individual- and population-level health. If someone incompletely 'adheres' to their treatment (does not take all their medicine as recommended) this can result in the same problems, but the impact of this depends on the drugs being used, due to their differing properties. Poor adherence to treatment costs hundreds of billions of dollars globally each year.For many chronic diseases, we do not know how much medicine it is safe for patients not to take and still be cured. Taking at least eight of every 10 doses across the entire length of treatment is often said to be important, but this lacks good evidence and is highly simplistic, especially given how much drugs vary from disease to disease.This study aims to use different methodologies and real-life, detailed, adherence and treatment outcome data to decide how normal patient behaviour should influence our approach to treatment. Tuberculosis (TB) has been chosen as a model disease due to its global importance (10.4 million new patients, 1.4 million related deaths in 2015) and the need for better treatments. The Objectives are:1) Describe how, when and why poor adherence occurs during the six months of daily treatment, and how adherence is related to the outcome of treatment across different places.2) Determine how adherence patterns influence the development of drug resistance over time.3) Adapt a theoretical model to examine the impact of adherence on the best way to give treatment (e.g. slow release tablets).4) Draw together these strands of evidence to determine how adherence should alter our approach to treatment and how new regimens should be designed.This work will not only guide the best way of treating TB globally, but the methods used will also help to interpret how common adherence patterns should influence the use of drugs for other conditions in the real world. The best ways of dosing TB drugs can be included in new clinical trials to improve health services for patients and value for money. The way in which drug trial data is interpreted as reflecting real life by the people writing clinical guidance will be refined. The findings can also inform trials of tools to promote adherence.
设计不完善的慢性(即长期)疾病治疗方案会导致症状持续,甚至可能恶化。当一种疾病可以在人与人之间传播时,我们还面临着耐药性的发展和传播的风险,这是当细菌或病毒因基因改变而无法用正常药物治疗时。这危及个人和人群的健康。如果有人不完全“坚持”他们的治疗(没有按照建议服用所有药物),这可能会导致同样的问题,但其影响取决于所使用的药物,因为它们的性质不同。对于许多慢性病来说,我们不知道有多少药物是安全的,病人不服用而仍然可以治愈。在整个治疗过程中,每10剂中至少服用8剂通常被认为是重要的,但这缺乏良好的证据,并且非常简单化,特别是考虑到药物因疾病而异。这项研究旨在使用不同的方法和真实生活,详细的,依从性和治疗结果数据来决定正常患者行为如何影响我们的治疗方法。结核病(TB)由于其全球重要性(2015年有1040万新患者,140万相关死亡)和对更好治疗的需求而被选为模型疾病。目标是:1)描述在六个月的日常治疗期间,依从性差是如何、何时以及为什么发生的,以及依从性如何与不同地点的治疗结果相关。2)确定依从性模式如何影响耐药性随时间的发展。3)采用理论模型来检查依从性对最佳治疗方式的影响(例如缓释片剂)。4)将这些证据汇集在一起,以确定应如何改变我们的治疗方法,以及应如何设计新的治疗方案。这项工作不仅将指导全球治疗结核病的最佳方法,但所使用的方法也将有助于解释常见的坚持模式如何影响真实的世界中其他疾病的药物使用。结核病药物的最佳给药方式可以纳入新的临床试验,以改善患者的卫生服务,并提高资金效益。撰写临床指南的人将药物试验数据解释为反映真实的生活的方式将得到细化。这些发现也可以为促进依从性的工具的试验提供信息。
项目成果
期刊论文数量(10)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales: A national prospective cohort study.
- DOI:10.1016/j.vaccine.2023.01.023
- 发表时间:2023-02-10
- 期刊:
- 影响因子:5.5
- 作者:Bedston, Stuart;Lowthian, Emily;Jarvis, Christopher I;Akbari, Ashley;Beggs, Jillian;Bradley, Declan;de Lusignan, Simon;Griffiths, Rowena;Herbert, Laura;Hobbs, Richard;Kerr, Steven;Lyons, Jane;Midgley, William;Owen, Rhiannon K;Quint, Jennifer K;Tsang, Ruby;Torabi, Fatemeh;Sheikh, Aziz;Lyons, Ronan A
- 通讯作者:Lyons, Ronan A
Relational Dynamics of Treatment Behavior Among Individuals with Tuberculosis in High-Income Countries: A Scoping Review.
- DOI:10.2147/ppa.s313633
- 发表时间:2021
- 期刊:
- 影响因子:2.2
- 作者:Arakelyan S;Karat AS;Jones ASK;Vidal N;Stagg HR;Darvell M;Horne R;Lipman MCI;Kielmann K
- 通讯作者:Kielmann K
Additional file 1 of Impact of COVID-19 lockdown on the incidence and mortality of acute exacerbations of chronic obstructive pulmonary disease: national interrupted time series analyses for Scotland and Wales
附加文件 1:COVID-19 封锁对慢性阻塞性肺疾病急性加重的发病率和死亡率的影响:苏格兰和威尔士的国家间断时间序列分析
- DOI:10.6084/m9.figshare.14603077
- 发表时间:2021
- 期刊:
- 影响因子:0
- 作者:Alsallakh M
- 通讯作者:Alsallakh M
Uptake, effectiveness and safety of COVID-19 vaccines in children and young people in Scotland: Protocol for early pandemic evaluation and enhanced surveillance of COVID-19 (EAVE II).
- DOI:10.7189/jogh.11.05026
- 发表时间:2021
- 期刊:
- 影响因子:7.2
- 作者:Adeloye D;Katikireddi SV;Woolford L;Simpson CR;Shah SA;Agrawal U;Richie LD;Swann OV;Stock SJ;Robertson C;Sheikh A;Rudan I
- 通讯作者:Rudan I
COVID-19 vaccine uptake, effectiveness, and waning in 82,959 health care workers: A national prospective cohort study in Wales.
COVID-19-82,959名卫生保健工作者的疫苗摄取,有效性和减弱:威尔士的一项国家前瞻性队列研究。
- DOI:10.1016/j.vaccine.2021.11.061
- 发表时间:2022-02-16
- 期刊:
- 影响因子:5.5
- 作者:Bedston S;Akbari A;Jarvis CI;Lowthian E;Torabi F;North L;Lyons J;Perry M;Griffiths LJ;Owen RK;Beggs J;Chuter A;Bradley DT;de Lusignan S;Fry R;Richard Hobbs FD;Hollinghurst J;Katikireddi SV;Murphy S;O'Reily D;Robertson C;Shi T;Tsang RSM;Sheikh A;Lyons RA
- 通讯作者:Lyons RA
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Helen Stagg其他文献
Helen Stagg的其他文献
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{{ truncateString('Helen Stagg', 18)}}的其他基金
Non-adherence to treatment: a methodological approach to compensating for its impact in chronic infections, using tuberculosis as a model disease.
不坚持治疗:一种以结核病为模型疾病来补偿其对慢性感染影响的方法。
- 批准号:
MR/R008345/2 - 财政年份:2023
- 资助金额:
$ 134.97万 - 项目类别:
Fellowship
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Non-adherence to treatment: a methodological approach to compensating for its impact in chronic infections, using tuberculosis as a model disease.
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