Kane Sunanda V
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Drugs. 2008;68(18):2601-9. doi: 10.2165/0003495-200868180-00006.
This review examines studies of patient adherence to 5-aminosalicylic acid therapy conducted outside the context of a controlled therapy trial, considers the reasons why patients do not adhere to their medication and its consequences, and interventions to improve adherence and disease outcomes. Non-adherence in the inflammatory bowel disease population tends to mirror other chronic illnesses, in the range of 40-60%. Factors that appear to affect adherence include younger age, single status, heavy pill burden, perception of lack of benefit and feeling uninformed about the effect of medication. Three important outcomes of non-adherence include increased risk for disease activity, increased healthcare costs and the possible increased risk of dysplasia/colorectal cancer. Strategies to improve adherence include patient education and 'health literacy', along with discussing patient misperceptions and fears on an individual basis, decreasing the daily regimen and switching to high-dose formulations, and incorporating patient self-management techniques into practice.
本综述考察了在对照治疗试验背景之外进行的患者对5-氨基水杨酸疗法依从性的研究，探讨了患者不坚持服药的原因及其后果，以及提高依从性和改善疾病预后的干预措施。炎症性肠病患者的不依从率往往与其他慢性病相似，在40%至60%之间。似乎影响依从性的因素包括年龄较小、单身状态、服药负担重、认为无益处以及对药物效果了解不足。不依从的三个重要后果包括疾病活动风险增加、医疗费用增加以及发育异常/结直肠癌风险可能增加。提高依从性的策略包括患者教育和“健康素养”，以及根据个体情况讨论患者的误解和恐惧，减少每日用药方案并改用高剂量制剂，以及将患者自我管理技术纳入实践。
