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帕金森病中的药物依从性。

Drug adherence in Parkinson's disease.

作者信息

Leopold Norman A, Polansky Marcia, Hurka Marcia R

机构信息

Division of Neurology, Department of Medicine, Crozer-Chester Medical Center, Upland, Pennsylvania 19013, USA.

出版信息

Mov Disord. 2004 May;19(5):513-7. doi: 10.1002/mds.20041.

Abstract

Physicians modify drug schedules in response to their patients' clinical responses. Failure to relieve patients' symptoms or the emergence of drug-related side effects may reflect nonadherence to a prescribed drug schedule rather than incorrect therapeutic physician decisions. Using a medication questionnaire and a computerized medication event monitoring system (MEMS) to monitor medication use, nonadherence of drug use was examined in subjects with Parkinson's disease (PD). We report that prescription nonadherence in PD subjects was common and approximated that reported in other chronic diseases. During a 28-day observation period, only 4 of 39 subjects had complete schedule adherence, i.e., no missed, extra, or mistimed doses. Using a questionnaire, 24.3% of subjects acknowledged missing any doses but the computerized MEMS recorded that 51.3% of subjects missed at least one dose per week and 20.5% of subjects missed three or more doses per week. Mistiming of doses was admitted by 73% of subjects but 82.1% had recorded mistimed doses. Of multiple sociodemographic and disease-related items examined, only gender and level of education were statistically related to nonadherence.

摘要

医生会根据患者的临床反应调整用药时间表。未能缓解患者症状或出现药物相关副作用可能反映出未遵守规定的用药时间表,而非医生的治疗决策有误。通过使用药物问卷和计算机化药物事件监测系统(MEMS)来监测用药情况,对帕金森病(PD)患者的用药依从性进行了研究。我们发现,PD患者的处方不依从情况很常见,与其他慢性病的报告情况相近。在为期28天的观察期内,39名受试者中只有4人完全遵守用药时间表,即没有漏服、多服或服药时间错误的情况。通过问卷调查,24.3%的受试者承认有漏服情况,但计算机化MEMS记录显示,51.3%的受试者每周至少漏服一剂,20.5%的受试者每周漏服三剂或更多。73%的受试者承认有服药时间错误的情况,但82.1%的受试者有服药时间错误的记录。在检查的多个社会人口统计学和疾病相关因素中,只有性别和教育程度与不依从性有统计学关联。

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