Richards H L, Fortune D G, O'Sullivan T M, Main C J, Griffiths C E
Department of Behavioural Medicine, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom.
J Am Acad Dermatol. 1999 Oct;41(4):581-3.
Poor compliance with treatment advice in chronic conditions, such as psoriasis, represents a major challenge to health care professionals. Previous research suggests that the rate of noncompliance in chronic conditions may be as high as 40%.
This study was designed to examine self-reported compliance in patients with psoriasis.
We undertook an anonymous postal survey sent to consecutive patients with psoriasis attending a tertiary psoriasis specialty clinic.
Thirty-nine percent of participants reported that they did not comply with the treatment regimen recommended. The noncompliant group had a higher self-rated severity of psoriasis (t = -2.16, P =. 03), were younger (t = 3.28, P =.001), and had a younger age at onset (t = 2.35, P =.02) than those who were compliant. The noncompliant group reported that psoriasis had a greater impact on daily life (t = -2.23, P =.028), but general well-being was not significantly different from those who complied (t =.47, P = not significant).
Patients who reported intentional noncompliance with treatment advice were more likely to believe that both psoriasis and its treatment interfered with their quality of life but not overall well-being. The impact of treatment on daily life highlights the importance of joint decision making in planning treatment.
在银屑病等慢性病中，患者对治疗建议的依从性差是医疗保健专业人员面临的一项重大挑战。先前的研究表明，慢性病的不依从率可能高达40%。
本研究旨在调查银屑病患者自我报告的依从性情况。
我们对一家三级银屑病专科诊所的连续就诊的银屑病患者进行了匿名邮寄调查。
39%的参与者报告称他们未遵守推荐的治疗方案。与依从的患者相比，不依从组的银屑病自我评定严重程度更高（t = -2.16，P = 0.03），年龄更小（t = 3.28，P = 0.001），发病年龄也更小（t = 2.35，P = 0.02）。不依从组报告称银屑病对日常生活的影响更大（t = -2.23，P = 0.028），但总体幸福感与依从组无显著差异（t = 0.47，P = 无显著性差异）。
报告故意不遵守治疗建议的患者更有可能认为银屑病及其治疗都会干扰他们的生活质量，但不会影响总体幸福感。治疗对日常生活的影响凸显了在制定治疗方案时共同决策的重要性。
