一项系统性审查揭示了对他类药物坚持的可修改影响
Javiera Rosenberg1, Smaragda Lampridou1,2, Amelia Moores1
1Department of Surgery & Cancer, Imperial College London, London, UK.
Patient preference and adherence
|January 9, 2025
概括
改善他类药物的坚持需要了解患者的知识,信仰和社会因素. 解决这些可改变的影响可以提高心血管疾病的预防和全球患者的结果.
科学领域:
- 心血管医学 心血管医学
- 健康心理学 心理健康心理学
- 证据综合 证据综合
背景情况:
- 类药物显著降低了心血管疾病 (CVD) 风险,但全球坚持率仍不理想.
- 现有的关于他类药物坚持性的审查存在局限性,包括不充分整合定性和定量数据.
- 识别可修改的障碍和促进因素对于改善患者坚持治疗和心血管疾病的结果至关重要.
研究的目的:
- 系统地审查和综合影响他类药物坚持的可修改障碍和促进因素.
- 使用理论领域框架 (TDF) 进行结构化分析的坚持因素.
- 发现证据缺口,特别是关于代表性不足的患者群体.
主要方法:
- 在Embase,MEDLINE,PsycINFO和CINAHL (1998-2023) 进行了全面的系统文献搜索.
- 根据TDF领域进行数据提取和编码,并注明证据类型 (质量/数量).
- 综合发现,以确定不同患者群体对他类药物坚持的关键影响.
主要成果:
- 包括来自20个国家的70项研究;只有一个专注于少数民族.
- 影响遵守的关键TDF领域包括"关于后果的信念"",知识"",环境背景和资源"和"社会影响".
- 诸如疾病知识,感知到的威胁,感知到的好处和患者与医疗服务提供者的沟通等因素是显著的;副作用显示出不一致的关联.
结论:
- 这次审查确定了特定的,可修改的因素,可以提高他类药物的坚持.
- 干预措施应侧重于提高患者的知识,解决对后果的信念,并利用社会支持.
- 未来的研究必须优先考虑代表性不足的群体,以制定包容性和有效的坚持战略.
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