在患有的人群中,药物坚持的障碍
Maria Andrea Donahue1, Hammad Akram1, Julianne D Brooks1
1Department of Neurology (MAD, HA, JDB, SFZ, LM), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Behavioral Medicine and Clinical Psychology (ACM), Cincinnati Children's Hospital Medical Center; University of Cincinnati-College of Medicine (ACM), Cincinnati, OH; Epilepsy Foundation (JV, AK, KF, BEF), Bowie, MD; Department of Neurology (SWB), Keck Medicine of University of Southern California, Los Angeles, CA; Department of Neurology (STH), Barrow Neurological Institute, Phoenix, AZ; Department of Neurology (DMF), UC Gardner Neuroscience Institute, Cincinnati, OH; Neurology Department (WHT), Penn State Health Children's, Hershey, PA; Neurology Department (DS), UT Southwestern Medical Center Children's Health, Dallas, TX; CHOC Neuroscience Center (DJP), Children's Hospital of Orange County, Orange, CA; Department of Neurology (JP), University of Colorado School of Medicine, Denver, CO; and Department of Pediatrics (JB), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
药物坚持障碍对患者的控制有显著影响. 通过查和行为策略来解决这些障碍,可以改善PWE的结果.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 药理学 药理学是指药理学的学科.
背景情况:
- 影响340万美国人,其中三分之一患有耐药性.
- 抗发作药物 (ASM) 是主要治疗方法,但不坚持是常见的,导致可预防的发作.
- 认识到坚持挑战对于有效的干预和改善患者结果至关重要.
研究的目的:
- 检查抗发作药物 (ASM) 坚持和患者 (PWE) 控制障碍之间的关系.
- 探索粘附障碍,控制和人口变量之间的关联.
主要方法:
- 一项横截面研究分析了来自8家美国诊所 (2020-2023) 的4917名个体的数据.
- 使用后勤回归来评估报告的坚持障碍和控制之间的联系.
- 探索了人口统计学变量 (性别,种族,种族) 寻找潜在的关联.
主要成果:
- 18.4%的人报告了坚持障碍; 37.7%的人实现了控制.
- 最重要的障碍包括忘记ASM (48.2%),副作用 (29.2%) 和缺乏有效性 (21.3%).
- 报告的坚持障碍与控制的几率显著降低 (OR 0.6,95% CI 0.5-0.7).
结论:
- 在成年PWE中存在对ASM坚持和不充分的控制的重大障碍.
- 在临床实践中,建议对坚持障碍进行标准化查和量身定制的行为干预措施.
- 针对坚持障碍的个性化护理策略可以提高控制和患者的结果.
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