Richter Anke, Anton Susan F, Koch Peter, Dennett Susan L
RTI-Health Solutions, Research Triangle Park, North Carolina 27709, USA.
Clin Ther. 2003 Aug;25(8):2307-35; discussion 2306. doi: 10.1016/s0149-2918(03)80222-9.
Dosing schedules may be one important factor determining whether patients take their prescribed medication. Schedules may influence whether a patient stays on the prescribed therapy and, if so, the degree to which the regimen is followed. Both factors are important determinants of health outcomes and health care costs.
The goal of this study was to investigate the impact of reducing dose frequency on health outcomes and health care costs.
Articles from peer-reviewed journals were identified from the medical literature databases MEDLINE, International Pharmaceutical Abstracts, and HealthSTAR for the years 1985 through 2002. The search included all references that reported on the impact of a change of dose frequency on chronic disease. Search terms used were combinations of dose frequency, dose schedule, and dosing and efficacy, safety, clinical effectiveness, preferences, adherence, compliance, persistence, health-related quality of life, patient satisfaction, resource use, and costs.
Reducing the number of daily doses through extended-release formulations or newer drugs has frequently been shown to provide the patient with better symptom control in a number of disease states. Overall improvements were seen in adherence, patient quality of life, patient satisfaction, and costs. However, results of some studies indicate that not all patients, medications, or diseases may be candidates for reduced dosing due to the potential effects on symptom control, incidence of adverse events, and overcompensation for missed doses.
Where feasible, reducing dose frequency may offer benefits for the patient in terms of health outcomes and for the health care budget holder in terms of costs.
给药方案可能是决定患者是否服用处方药物的一个重要因素。给药方案可能会影响患者是否坚持规定的治疗，如果坚持治疗，还会影响遵循治疗方案的程度。这两个因素都是健康结果和医疗保健成本的重要决定因素。
本研究的目的是调查降低给药频率对健康结果和医疗保健成本的影响。
从1985年至2002年的医学文献数据库MEDLINE、《国际药学文摘》和HealthSTAR中检索同行评审期刊上的文章。检索包括所有报告给药频率变化对慢性病影响的参考文献。使用的检索词包括给药频率、给药方案、给药与疗效、安全性、临床有效性、偏好、依从性、顺应性、持续性、健康相关生活质量、患者满意度、资源利用和成本的组合。
通过缓释制剂或新药减少每日给药次数，在许多疾病状态下经常被证明能为患者提供更好的症状控制。在依从性、患者生活质量、患者满意度和成本方面都有总体改善。然而，一些研究结果表明，由于对症状控制、不良事件发生率和漏服剂量的过度补偿可能产生的潜在影响，并非所有患者、药物或疾病都适合减少给药。
在可行的情况下，降低给药频率可能在健康结果方面为患者带来益处，在成本方面为医疗保健预算管理者带来益处。
