药物不服药 - - 定义,测量,患病率和原因:回顾过去20年,展望未来
Sarah C E Chapman1, Amy H Y Chan2
1Centre for Adherence Research and Education, Institute of Pharmaceutical Science, King's College London, London, United Kingdom.
Frontiers in pharmacology
|March 24, 2025
概括
药物不坚持是复杂的,因个人和治疗不同而随着时间的推移而变化. 新技术和行为模型为患者提供了更细致的理解和个性化的支持.
科学领域:
- 药理学和制药学 药理学和制药学
- 行为科学 行为科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 2003年由世卫组织定义的药物不服药,不是简单的患者分类,而是个体内和治疗过程中变化的动态现象.
- 了解不服药模式至关重要,因为不同的模式,即使有相同的不服药百分比,也会导致不同的临床结果,早期停药通常会导致最差的结果.
- 文献正在从专注于实施转变为更细微的观点,由技术进步驱动.
研究的目的:
- 提供对药物不服药的细微讨论,超越简单的分类.
- 探索新技术和行为模型如何增强对不坚持的理解.
- 突出更多个性化的患者支持策略的潜力.
主要方法:
- 利用来自电子不服药监测器,生物标志物和处方补充数据 ("大数据") 的数据进行细分评估.
- 从可穿戴设备中整合生物物理标记物与粘附数据.
- 使用验证的自我报告措施来分析研究和实践中的不遵守.
- 应用新的行为模型 (例如,COM-B,MACO) 来合成不坚持的决定因素.
主要成果:
- 越来越多的证据表明显著的非启动 (约. 20%) 和未达到最佳水平的实施 (30-50%) 的处方治疗.
- 长期随访显示,某些疾病的戒断率很高 (80-100%).
- 技术进步使得我们能够更细致地了解不坚持的流行率和模式.
结论:
- 药物不服药是一个多方面的问题,受个人,社会和环境因素的影响.
- 新技术和行为框架有助于更深入地了解不坚持的决定因素.
- 通过动态过程和复杂的互动来提供个性化的支持策略,对于改善患者的治疗结果至关重要.
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