加强患者遵守药物处方的干预措施:科学综述
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
概括
改善药物坚持是非常重要的. 复杂的干预措施表现出适度的成功,但目前的方法往往是无效的,需要创新的方法,以便更好地患者遵守处方.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 行为医学是一种行为医学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 缺乏对处方治疗的坚持是普遍存在的问题.
- 不良的坚持显著降低了医疗治疗的有效性.
- 这一系统性审查解决了患者对药物的坚持的挑战.
研究的目的:
- 系统地审查旨在改善患者遵守处方药物的干预措施的随机对照试验 (RCT).
- 评估不同干预策略对药物坚持和治疗结果的有效性.
主要方法:
- 进行全面的数据库搜索 (MEDLINE,CINAHL,EMBASE,科克兰图书馆等) 对于从1967年到2001年8月出版的RCT来说.
- 纳入标准:未被证实的RCT,医疗/精神疾病,测量依从性和结果,≥80%的随访,以及≥6个月的积极初始发现的随访.
- 数据提取包括研究设计,干预,对照,坚持率和患者结果.
主要成果:
- 研究太多样化,无法进行元分析.
- 49%的干预措施 (19/39) 显著增加了药物服药.
- 只有17项研究报告了治疗结果的显著改善;有效的干预措施是复杂的,并且具有适度的效果.
结论:
- 目前的药物坚持干预措施往往是复杂的,劳动密集的,而且效果不可预测.
- 由于目前的药物坚持水平,实现药物的全部益处受到阻碍.
- 对改善患者遵守处方的创新策略的进一步研究是必不可少的.
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