Schwartz Gail F
Glaucoma Consultants, Greater Baltimore Medical Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21204, USA.
Curr Opin Ophthalmol. 2005 Apr;16(2):114-21. doi: 10.1097/01.icu.0000156139.05323.26.
To summarize research published between 1980 and October 2004 regarding compliance (the extent to which patients' behaviors correspond with providers' recommendations) and persistency (total time on therapy) in patients diagnosed with open-angle glaucoma or ocular hypertension; to suggest approaches ophthalmologists might consider to improve compliance and persistency; and to identify areas warranting future research.
Medication compliance, the focus of most compliance-related research, has been measured using a variety of methods including patient self-reports, the medication possession ratio, and electronic monitoring. Noncompliance rates of at least 25% commonly have been reported. The primary obstacles to medication compliance appear to be situational/environmental (e.g., being away from home or a change in routine) or related to the medication regimen (e.g., side effects or complexity). Persistency with ocular hypotensive therapies has been found to be poor. Retrospective cohort studies using survival analyses have reported that fewer than 25% of patients are persistent over 12 months.
Accurately assessing patient compliance and persistency is important to optimizing patient care. Physicians may mistake either medication noncompliance or lack of persistency with poor efficacy. Such errors would likely increase health care costs if they result in unnecessary changes to a patient's therapeutic regimen or in surgery.
总结1980年至2004年10月间发表的关于开角型青光眼或高眼压症患者的依从性（患者行为与医疗服务提供者建议的相符程度）和持续性（治疗总时长）的研究；提出眼科医生可考虑的提高依从性和持续性的方法；并确定值得未来研究的领域。
药物依从性是大多数依从性相关研究的重点，已通过多种方法进行测量，包括患者自我报告、药物持有率和电子监测。通常报告的不依从率至少为25%。药物依从性的主要障碍似乎是情境/环境因素（如离家或日常安排改变）或与药物治疗方案相关（如副作用或复杂性）。已发现眼压降低治疗的持续性较差。使用生存分析的回顾性队列研究报告称，超过12个月仍持续治疗的患者不到25%。
准确评估患者的依从性和持续性对于优化患者护理很重要。医生可能会将药物不依从或缺乏持续性误认为疗效不佳。如果这些错误导致对患者治疗方案进行不必要的更改或进行手术，可能会增加医疗成本。
