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糖尿病药物援助项目:有效性与依从性的关系

Diabetes mellitus medication assistance program: relationship of effectiveness to adherence.

作者信息

Horswell Ronald L, Wascom Charles K, Cerise Frederick P, Besse Jay A, Johnson Jolene K

机构信息

Statistical Analysis, Louisiana State University Health Care Services Division, Baton Rouge, LA 70821, USA.

出版信息

J Health Care Poor Underserved. 2008 Aug;19(3):677-86. doi: 10.1353/hpu.0.0062.

Abstract

This retrospective study examines the effect of a medication assistance program (MAP) on HbA1c levels in an uninsured, low-income, type 2 diabetes population. It also examines the degree to which improvement in HbA1c level varied with adherence to medication regimens among those patients using the MAP. The MAP was found to have a mean effect of -0.60% on HbA1c levels. However, MAP users differed in how strictly they adhered to medication regimens, as measured by number of refill opportunities taken. The MAP's effect on HbA1c varied monotonically with adherence level, with greater adherence leading to greater HbA1c improvement. Never refilling the prescription (complete nonadherence) led to no change in HbA1c, while complete adherence led to an estimated -0.88% improvement in HbA1c. Further study is needed to investigate factors related to non-adherence within medication assistance programs and the effect of such programs on other patient outcomes.

摘要

这项回顾性研究考察了药物援助项目(MAP)对未参保的低收入2型糖尿病患者糖化血红蛋白(HbA1c)水平的影响。该研究还考察了在使用MAP的患者中,HbA1c水平的改善程度与药物治疗方案依从性之间的变化关系。研究发现,MAP对HbA1c水平的平均影响为-0.60%。然而,通过计算取药次数来衡量,MAP使用者在药物治疗方案的严格依从程度上存在差异。MAP对HbA1c的影响随依从程度呈单调变化,依从性越高,HbA1c改善越明显。从未取药(完全不依从)导致HbA1c无变化,而完全依从则使HbA1c估计改善-0.88%。需要进一步研究以调查药物援助项目中与不依从相关的因素,以及此类项目对其他患者预后的影响。

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