Bogart L M, Catz S L, Kelly J A, Benotsch E G
Department of Psychology, Kent State University, Ohio 44242-0001, USA.
Med Decis Making. 2001 Jan-Feb;21(1):28-36. doi: 10.1177/0272989X0102100104.
New medications for HIV reduce mortality and morbidity but require strict adherence. Thus, physicians treating HIV-positive patients must weigh both disease severity and likelihood of adherence when deciding whether to start patients on treatment. A national sample of 495 physicians surveyed via mail responded to clinical scenarios depicting HIV-positive patients and indicated whether they would start patients on medication (response rate = 53%). Scenarios varied on the patient characteristics of gender, disease severity, ethnicity, and risk group. Physicians predicted that patients with less severe disease, former injection drug users, and African American men would be less likely to adhere. Perceived adherence and disease severity influenced treatment decisions. Results are discussed in the context of attitudes about minority groups and injection drug users, which may influence adherence judgments in practice settings. Psychological research to identify better methods of predicting medication adherence may serve to inform medical decision making.
治疗艾滋病病毒（HIV）的新型药物可降低死亡率和发病率，但需要严格坚持用药。因此，治疗HIV阳性患者的医生在决定是否让患者开始治疗时，必须权衡疾病的严重程度和坚持用药的可能性。通过邮件对495名医生进行的全国抽样调查，他们对描述HIV阳性患者的临床案例做出回应，并表明是否会让患者开始用药（回复率 = 53%）。案例在患者的性别、疾病严重程度、种族和风险群体等特征方面有所不同。医生预测，疾病不太严重的患者、曾经注射吸毒者以及非裔美国男性坚持用药的可能性较小。感知到的坚持用药情况和疾病严重程度影响了治疗决策。研究结果将在对少数群体和注射吸毒者态度的背景下进行讨论，这些态度可能会在实际环境中影响对坚持用药情况的判断。识别更好预测药物坚持使用方法的心理学研究可能有助于为医疗决策提供信息。
