炎症性肠病中的药物不服药:系统性审查,确定风险因素和干预机会
Kathryn King1, Wladyslawa Czuber-Dochan1, Trudie Chalder2
1Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London SE1 8WA, UK.
Pharmacy (Basel, Switzerland)
|February 25, 2025
概括
了解炎症性肠病 (IBD) 药物坚持是缓解的关键. 诸如理解不足,可访问性和情绪等因素会影响坚持,副作用是主要的原因.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 炎症性肠病 (IBD) 管理依赖于药物坚持缓解.
- 相当数量的IBD患者不遵守处方治疗,影响疾病控制.
- 确定坚持因素对于有效的IBD管理至关重要.
研究的目的:
- 审查和综合对影响炎性肠病药物坚持因素的定量和定性研究.
- 确定IBD患者不坚持的可修改和不可修改的风险因素.
- 探索不同测量方法对报告的坚持率的影响.
主要方法:
- 2011年至2023年间发表的关于IBD药物治疗的定量和定性研究的系统审查.
- 包括79项研究,涉及36589名参与者.
- 对坚持因素的分析,包括临床,心理和社会人口统计学变量.
主要成果:
- 根据测量方法,坚持率有很大差异,药物补充率 (72-79%) 比自我报告 (10.7-28.7%) 高.
- 关键的可修改风险包括缺乏治疗理解,药物可获得性和组织挑战.
- 心理因素 (抑郁,焦虑,负面信念) 和临床变量 (治疗类型,疾病活性) 与不坚持相关.
- 非可修改的风险包括年轻的年龄,女性性别和有限的财务状况. 副作用是不服药的主要原因.
结论:
- 有一个复杂而往往矛盾的证据存在关于IBD不坚持因素,受测量技术的影响.
- 建议采取干预措施,重点是简化药物治疗方案,改善可访问性和加强患者教育.
- 解决心理因素和提供坚持支持可以改善患者的结果和疾病缓解.
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