Mishra Pranaya, Hansen Ebba Holme, Sabroe Svend, Kafle Kumud Kumar
The Danish University of Pharmaceutical Sciences, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
Patient Educ Couns. 2006 Oct;63(1-2):29-37. doi: 10.1016/j.pec.2005.08.006. Epub 2005 Oct 19.
To investigate the association between the behaviour of health professionals as reported by patients, the quality of communication, patients' communication about their disease, and non-adherence to Directly Observed Tuberculosis Treatment Short-course, DOTS.
This study was designed as a case-control study based on 50 cases (non-adherents) and 100 controls (adherents), conducted in a hilly western district in Nepal. The participation rate was 80% for 50 cases and 95% for 100 controls. All covariates with p-value<or=0.2 were included in a multivariate logistic regression model to identify the factors significantly associated with treatment non-adherence.
The analysis identified that poor-grade communication (OR=11.2; CI 2.5-50.4) and fair-grade communication (OR=2.7; CI 1.2-6.3) between patients and dispensers were significantly associated with non-adherence.
Better communication between health professionals, particularly dispensers, and patients is essential for improving treatment adherence in TB treatment, even under DOTS.
Drug dispensers should be trained to develop their communication skills about the use of medications, associated side effects, benefits and risk of non-adherence, as well as to respect the individual patient's autonomy and integrity.
调查患者报告的卫生专业人员行为、沟通质量、患者对自身疾病的沟通情况与不坚持结核病短程直接督导治疗（DOTS）之间的关联。
本研究设计为病例对照研究，在尼泊尔西部一个山区开展，以50例（不坚持治疗者）为病例组，100例（坚持治疗者）为对照组。50例病例的参与率为80%，100例对照的参与率为95%。所有p值≤0.2的协变量都纳入多因素逻辑回归模型，以确定与治疗不坚持显著相关的因素。
分析发现，患者与药剂师之间沟通不良（比值比[OR]=11.2；可信区间[CI]2.5 - 50.4）和沟通一般（OR=2.7；CI 1.2 - 6.3）与不坚持治疗显著相关。
卫生专业人员，尤其是药剂师与患者之间更好的沟通对于提高结核病治疗的依从性至关重要，即使在DOTS模式下也是如此。
应培训药剂师，以提高他们在药物使用、相关副作用、依从性的益处和风险方面的沟通技巧，同时尊重患者的个人自主性和完整性。
