薬の処方箋に対する患者の遵守を強化するための介入:科学的なレビュー
Heather P McDonald1, Amit X Garg, R Brian Haynes
1Health Research Methodology Program, McMaster University School of Graduate Studies, Hamilton, Ontario, Canada.
JAMA
|December 11, 2002
まとめ
薬の服用習慣を改善することは極めて重要です. 複雑な介入は,控えめな成功を示しますが,現在の方法はしばしば無効であり,処方箋への患者の遵守を向上させるための革新的なアプローチを必要とします.
科学分野:
- 医療サービス 研究 医療サービス
- 行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral Medicine) とは,行動医学 (Behavioral
- 薬理学 薬理学とは
背景:
- 処方された治療法への従順度が低いことは,広範な問題です.
- 順守の不良は,医療治療の有効性を著しく低下させる.
- このシステマティック・レビューは,患者による薬物投与の順守に関する課題に取り組んでいます.
研究 の 目的:
- 処方薬に対する患者の遵守を改善することを目的とした介入のランダム化対照試験 (RCT) を体系的にレビューする.
- 異なる介入戦略の有効性を評価し,薬の投与順守と治療結果の評価を行う.
主な方法:
- 総合的なデータベース検索 (MEDLINE,CINAHL,EMBASE,コクラン図書館など) 1967年から2001年8月に出版されたRCTについてです.
- 含有基準:根拠のないRCT,医学/精神疾患,測定されたアデレンスおよびアウトカム,≥80%のフォローアップ,および前向きな初期発見に対する≥6ヶ月のフォローアップ.
- データ抽出には,研究設計,介入,対照群,遵守率,患者のアウトカムが含まれていました.
主要な成果:
- 研究はメタ分析には多岐にわたらなかった.
- 介入の49% (19/39) は,薬の投与順守を著しく増加させた.
- 治療結果の有意な改善を報告したのは17の研究のみで,効果的な介入は複雑で,効果は控えめでした.
結論:
- 現在の薬物耐用性対策は,しばしば複雑で,労力を要し,予測できないほど効果的です.
- 薬剤の完全な利点を達成することは,現在のアデバーンスレベルによって妨げられています.
- 処方箋への患者の遵守を改善するための革新的な戦略に関するさらなる研究は不可欠です.
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