基于咨询的干预措施,以优化初级保健中的药物坚持:系统审查
Caitriona Callan1, Jadine Scragg1, Richard Stevens1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Family practice
|March 3, 2026
概括
咨询干预措施可能会稍微提高2型糖尿病和呼吸道疾病的药物坚持. 然而,缺乏临床益处或在其他疾病中有效性的强有力的证据,这凸显了需要可行的干预措施的需要.
科学领域:
- 临床药房 临床药房
- 基于证据的医学基于证据的医学.
- 公共卫生 公共卫生
背景情况:
- 药物坚持对于管理慢性疾病和预防并发症至关重要.
- 基于咨询的干预措施是初级保健机构中可行的方法.
- 关于这些干预措施对预防性药物有效性的证据需要综合.
研究的目的:
- 综合基于咨询的干预措施的证据,以促进药物坚持和临床结果.
- 评估这些干预措施在初级保健中的可行性.
主要方法:
- 随机试验的系统审查和元分析 (2015年以后).
- 包括为心血管疾病,2型糖尿病 (T2DM),慢性呼吸道疾病或骨质疏松症处方预防药物的成年人.
- 评估了依从性和临床结果;元分析使用了逆方差异异质的方法.
主要成果:
- 包括41项研究 (n=26,114). 对T2DM和慢性呼吸道疾病的适度依从性改善,但对灵敏度分析不强大.
- 对心血管预防或骨质疏松症没有显著的粘附效应.
- 没有观察到临床结果 (例如血压,HbA1c) 或住院治疗的显著改善. 发现了高度的异质性和偏差风险.
结论:
- 基于咨询的干预措施显示,在T2DM和慢性呼吸道疾病中,适度的坚持改善的潜力.
- 目前缺乏关于临床益处或在其他疾病中有效性的强有力的证据.
- 干预可行性是未来研究和临床翻译的关键.
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