Márquez Contreras Emilio, de la Figuera von Wichmann Mariano, Roig Ponsa Laura, Naval Chamosa Jordi
Centro de Salud La Orden, Puerto 7, D 21003 Huelva, Spain.
Aten Primaria. 2007 Aug;39(8):417-23. doi: 10.1157/13108616.
To evaluate physicians' knowledge of therapy compliance, their attitudes towards it and their training needs in this field.
Transversal, descriptive study using a questionnaire.
Primary care centres in Spain.
Three thousand and thirty-four general practitioners.
Definition of non-compliance, non-compliance in their own consultations and in the rest of Spain, methods of measurement, causes, association with therapy failure, efficacy and use of compliance-enhancing strategies, and need for training.
Most participants (92%; 95% CI, 91.1-92.9) defined non-compliance as patients' failure to take 5%-20% of their pills. A total of 32.4% (95% CI, 30.9%-33.9%) of the physicians estimated that less than 10% of their patients were non-compliers, whereas 6.8% (95% CI, 6.0-7.6) thought this was also the rate in the rest of Spain. The preferred methods of measurement were patient response (77.0%; 75.7-78.4) and their own clinical experience (76.0%; 74.6-77.4). About half (50.7%) believed that lack of compliance was associated with therapy failure in more than 50% of cases. The presence of adverse side-effects was considered a very important cause of poor compliance by 81.9%. The most common and effective strategies were: use of single-dose drugs (84.3%; 83.1-85.5) and nursing support (84.9%; 83.8-86.0). Moreover, 65.2% (63.7-66.7) of the surveyed physicians had not received any education about compliance as medical students and 42% (40.4-43.6) said further training in compliance was needed.
A high percentage of physicians define compliance incorrectly and believe that other doctors have more non-complying patients than they do. They tend to favour non-validated measuring methods and they lack training.
评估医生对治疗依从性的了解、他们对其的态度以及在该领域的培训需求。
采用问卷调查的横向描述性研究。
西班牙的基层医疗中心。
3034名全科医生。
不依从的定义、他们自己诊疗中的不依从情况及西班牙其他地区的不依从情况、测量方法、原因、与治疗失败的关联、疗效以及提高依从性策略的使用情况，还有培训需求。
大多数参与者（92%；95%置信区间，91.1 - 92.9）将不依从定义为患者未服用5% - 20%的药物。共有32.4%（95%置信区间，30.9% - 33.9%）的医生估计其患者中不依从者不到10%，而6.8%（95%置信区间，6.0 - 7.6）认为西班牙其他地区也是这个比例。首选的测量方法是患者反馈（77.0%；75.7 - 78.4）和他们自己的临床经验（76.0%；74.6 - 77.4）。约一半（50.7%）的人认为超过50%的病例中不依从与治疗失败有关。81.9%的人认为出现不良副作用是依从性差的一个非常重要的原因。最常见且有效的策略是：使用单剂量药物（84.3%；83.1 - 85.5）和护理支持（84.9%；83.8 - 86.0）。此外，65.2%（63.7 - 66.7）的受访医生在医学院学习时未接受过任何关于依从性的教育，42%（40.4 - 43.6）的人表示需要进一步接受依从性方面的培训。
很大比例的医生对依从性的定义不正确，并且认为其他医生的不依从患者比他们自己的多。他们倾向于采用未经证实的测量方法，并且缺乏培训。
