Wroth Thomas H, Pathman Donald E
Department of Family Medicine, University of North Carolina at Chapel Hill, NC 27599, USA.
J Am Board Fam Med. 2006 Sep-Oct;19(5):478-86. doi: 10.3122/jabfm.19.5.478.
Although correlates of overall medication adherence have been studied, little is known about primary medication non-adherence-patients' failing to fill a prescription provided by a practitioner-and whether it relates to how patients view their physician, satisfaction with their care, and how easy or hard it is for them to travel for care.
This study uses telephone survey data from adults in 150 rural counties in 8 southeastern states. Bivariate and multivariable analyses were used to identify factors associated with adults' self-reports of delaying or not filling prescriptions.
Of the 3926 respondents who had received care in the previous year, 894 (21.6%) reported that they had delayed or did not fill a prescription over that time. In multivariate analysis, delaying or not filling prescriptions was more common among respondents who were under age 65, African American, reported incomes less than 25,000 dollars, and reported fair or poor health. Non-adherence was also more common among patients who reported transportation problems, a lack of confidence in their doctor's ability to help them, a lack of satisfaction with the concern shown them by their physicians, and a lack of satisfaction with how welcome and comfortable they are made to feel by office staff.
Prescription primary non-adherence is prevalent in the rural South. Adherence may be improved by remedying patient dissatisfaction and lack of confidence in their physicians as well as addressing transportation barriers.
尽管已经对总体药物依从性的相关因素进行了研究，但对于原发性药物不依从（即患者未按医生开具的处方取药）以及它是否与患者如何看待他们的医生、对医疗服务的满意度，以及他们就医的难易程度相关，我们知之甚少。
本研究使用了来自东南部8个州150个农村县成年人的电话调查数据。采用双变量和多变量分析来确定与成年人自我报告的延迟取药或未取药相关的因素。
在去年接受过医疗服务的3926名受访者中，有894人（21.6%）报告称他们在那段时间里延迟取药或未取药。在多变量分析中，延迟取药或未取药在65岁以下、非裔美国人、报告收入低于25000美元以及报告健康状况一般或较差的受访者中更为常见。在报告有交通问题、对医生帮助他们的能力缺乏信心、对医生给予他们的关心不满意，以及对办公室工作人员让他们感到受欢迎和舒适的程度不满意的患者中，不依从情况也更为常见。
在南方农村地区，原发性处方不依从情况普遍存在。通过解决患者的不满情绪、增强他们对医生的信心以及消除交通障碍，可能会提高依从性。
