Södergård B, Halvarsson M, Tully M P, Mindouri S, Nordström M-L, Lindbäck S, Sönnerborg A, Lindblad A K
Pharmaceutical Outcomes Research Group, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
J Clin Pharm Ther. 2006 Dec;31(6):605-16. doi: 10.1111/j.1365-2710.2006.00782.x.
The objectives were to assess the prevalence of adherence to antiretroviral treatment in Swedish human immunodeficiency virus (HIV)-infected patients and to evaluate factors associated with adherence.
All HIV-treated patients, who attended one of 30 (of a total of 32) Swedish infectious diseases clinics, during 7 months, were asked to complete an anonymous questionnaire containing the 9-item Morisky Medication Adherence Scale (MMAS) and questions about other factors potentially affecting adherence. The summary score of MMAS ranges from 1 to 13, where 13 indicates perfect adherence; patients scoring 11 or above (corresponding to 95% adherence level) were classified as 'adherent'.
In total 946 patients participated (response rate 97.5%). The proportion of patients who reported not missing a dose during the day prior to the completion of the questionnaire was 97% and the proportion classified as 'adherent' was 63%. 'Adherent' patients were more likely to have a good relationship with their health care professionals (P < 0.05) and not have problems with drugs or alcohol (P < 0.01). Being older (P < 0.01) and having a shorter time on current treatment (P < 0.01) and on treatment in total (P < 0.05) were factors also associated with good adherence.
Factors modifiable for interventions by health care professionals are patient-provider relationship, drug or alcohol problems and patients with long treatment periods.
评估瑞典人类免疫缺陷病毒(HIV)感染患者抗逆转录病毒治疗的依从性患病率,并评估与依从性相关的因素。
在7个月期间,要求所有在瑞典32家传染病诊所中的30家就诊的接受HIV治疗的患者填写一份匿名问卷,问卷包含9项的Morisky药物依从性量表(MMAS)以及关于其他可能影响依从性的因素的问题。MMAS的总分范围为1至13分,其中13分表示完全依从;得分11分及以上(相当于95%的依从水平)的患者被归类为“依从性好”。
共有946名患者参与(应答率97.5%)。在完成问卷前一天报告未漏服一剂药物的患者比例为97%,被归类为“依从性好”的患者比例为63%。“依从性好”的患者更有可能与他们的医护人员关系良好(P<0.05),且没有药物或酒精问题(P<0.01)。年龄较大(P<0.01)、当前治疗时间较短(P<0.01)以及总体治疗时间较短(P<0.05)也是与良好依从性相关的因素。
医护人员可进行干预的可改变因素包括患者与医护人员的关系、药物或酒精问题以及治疗时间长的患者。