慢性阻塞性肺疾病（COPD）患者呼吸道药物依从性的相关因素
Correlates of adherence to respiratory drugs in COPD patients.
作者信息
Laforest Laurent, Denis Francois, Van Ganse Eric, Ritleng Cecile, Saussier Christel, Passante Nadine, Devouassoux Gilles, Chatté Gerard, Freymond Nathalie, Pacheco Yves
机构信息
Unité de Neuro-Pharmaco-Epidémiologie, CHU: University Hospital Lyon, Lyon, France.
出版信息
Prim Care Respir J. 2010 Jun;19(2):148-54. doi: 10.4104/pcrj.2010.00004.
AIMS
To identify the correlates of accidental omissions and intentional interruptions of respiratory therapy in COPD.
METHODS
COPD patients (GOLD stages II-IV) were recruited by general practitioners or respiratory physicians. Patients reported in self-report questionnaires their adherence to respiratory drugs (over the past three months) and their perception of therapy.
RESULTS
179 patients were included (mean age 63 years, 24% females). 45% forgot their respiratory therapy, while 30% interrupted it in the absence of any perceived benefit. The risks of accidental omissions were significantly higher when patients complained about having too many medications to take on a daily basis (OR=2.35; 95%CI=1.13-4.89), and among current smokers (OR=2.14; 95%CI=1.07-4.29). Females were more likely to interrupt therapy intentionally (OR=2.40; 95%CI=1.04-5.53). Surprisingly, there was no significant relationship with the number of drugs actually taken by patients.
CONCLUSIONS
Adherence to respiratory drugs is inadequate in COPD patients. In order to improve adherence, patients' perception of the burden of therapy should not be overlooked.
目的
确定慢性阻塞性肺疾病（COPD）患者呼吸治疗意外遗漏和故意中断的相关因素。
方法
由全科医生或呼吸内科医生招募COPD患者（GOLD分级II-IV级）。患者通过自我报告问卷报告他们对呼吸药物的依从性（过去三个月）以及他们对治疗的看法。
结果
纳入179例患者（平均年龄63岁，24%为女性）。45%的患者忘记进行呼吸治疗，而30%的患者在未感觉到任何益处的情况下中断治疗。当患者抱怨每天要服用的药物太多时，意外遗漏的风险显著更高（比值比[OR]=2.35；95%置信区间[CI]=1.13-4.89），在当前吸烟者中也是如此（OR=2.14；95%CI=1.07-4.29）。女性更有可能故意中断治疗（OR=2.40；95%CI=1.04-5.53）。令人惊讶的是，这与患者实际服用的药物数量没有显著关系。
结论
COPD患者对呼吸药物的依从性不足。为了提高依从性，不应忽视患者对治疗负担的看法。
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