Tsai James C
Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, College of Physicians and Surgeons, New York, New York 10032, USA.
Curr Opin Ophthalmol. 2006 Apr;17(2):190-5. doi: 10.1097/01.icu.0000193078.47616.aa.
To summarize recent literature regarding medication adherence with a focus on the complexities inherent in glaucoma management.
Adherence to medications can be enhanced by undertaking the following strategies: enhanced patient education; improved dosing schedules; increased accessibility to healthcare (including longer hours, evening hours, and shorter wait times), and improved provider-patient relationships (e.g. increased trust). Patients may be less likely to forgo medication use due to cost pressures if the physician trust level is high. Recent studies suggest a role for baseline screening for adherence predictors and focused interventions in addressing modifiable risk factors for poor adherence (such as depression, stress, and lower education).
Many factors are associated with the lack of medication adherence in patients. The solution is likely to be multi-dimensional and employ combination strategy (must be individualized for the patient). Educational interventions involving patients, family members, or both can be effective in improving adherence.
总结近期关于药物依从性的文献，重点关注青光眼管理中固有的复杂性。
可通过以下策略提高药物依从性：加强患者教育；改进给药方案；增加医疗服务的可及性（包括延长工作时间、提供夜间服务以及缩短等待时间），以及改善医患关系（如增强信任）。如果医生的信任度较高，患者因成本压力而放弃用药的可能性可能会降低。近期研究表明，对依从性预测因素进行基线筛查以及针对可改变的依从性差风险因素（如抑郁、压力和低教育水平）进行有针对性的干预具有重要作用。
患者缺乏药物依从性与许多因素有关。解决方案可能是多维度的，并采用联合策略（必须针对患者个体化）。涉及患者、家庭成员或两者的教育干预措施在提高依从性方面可能有效。
