Lakatos László, Czeglédi Zsófia, Dávid Gyula, Kispál Zsófi, Kiss Lajos S, Palatka Károly, Kristóf Tünde, Molnár Tamás, Salamon Agnes, Demeter Pál, Miheller Pál, Szamosi Tamás, Banai János, Papp Mária, Bene László, Kovács Agota, Rácz István, Lakatos Péter László
Csolnoky Ferenc Megyei Kórház Belgyógyászati Centrum, Veszprém, Kórház u, 1, 8200.
Orv Hetil. 2010 Feb 14;151(7):250-8. doi: 10.1556/OH.2010.28805.
UNLABELLED: Previous studies have suggested an increasing use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD). Furthermore, a significant number of IBD patients fail to comply with treatment. The aim of our study was to evaluate the prevalence of non-adherence the use of CAM in Hungarian patients with IBD. METHODS: A total of 655 consecutive IBD patients (Crohn's disease [CD]: 344, age: 38.2 + or - 12.9 years; ulcerative colitis [UC]: 311, age: 44.9 + or - 15.3 years) were interviewed during the visit at specialists by self-administered questionnaire including demographic and disease-related data, as well as items analyzing the extent of non-adherence and CAM use. Patients taking more then 80% of each prescribed medicine were classified as adherent. RESULTS: The overall rate of self reported non-adherence (CD: 20.9%, UC: 20.6%) and CAM (CD: 31.7%, UC: 30.9%) use was not different between CD and UC. The most common causes of non-adherence were: forgetfulness (47.8%), too many/unnecessary pills (39.7%), being afraid of side effects (27.9%) and too frequent dosing. Most common forms of CAM were herbal tee (47.3%), homeopathy (14.6%), special diet (12.2%), and acupuncture (5.8%). In CD, disease duration, date of last follow-up visit, educational level and previous surgeries were predicting factors for non-adherence. Alternative medicine use was associated in both diseases with younger age, higher educational level and immunosuppressant use. In addition, CAM use in UC was more common in females and in patients with supportive psychiatric/psychological therapy. CONCLUSIONS: Non-adherence and CAM use is common in patients with IBD. Special attention should be paid to explore the identified predictive factors during follow-up visits to improve adherence to therapy and improving patient-doctor relationship.
未标注:先前的研究表明,炎症性肠病(IBD)患者对补充和替代医学(CAM)的使用呈上升趋势。此外,相当数量的IBD患者未能坚持治疗。我们研究的目的是评估匈牙利IBD患者不坚持使用CAM的患病率。 方法:在专家门诊期间,通过自我管理问卷对655例连续的IBD患者(克罗恩病[CD]:344例,年龄:38.2±12.9岁;溃疡性结肠炎[UC]:311例,年龄:44.9±15.3岁)进行访谈,问卷包括人口统计学和疾病相关数据,以及分析不坚持治疗程度和CAM使用情况的项目。服用每种处方药超过80%的患者被归类为依从性好。 结果:CD和UC患者自我报告的不坚持治疗率(CD:20.9%,UC:20.6%)和CAM使用率(CD:31.7%,UC:30.9%)没有差异。不坚持治疗的最常见原因是:遗忘(47.8%)、药丸过多/不必要(39.7%)、害怕副作用(27.9%)和给药过于频繁。CAM最常见的形式是草药茶(47.3%)、顺势疗法(14.6%)、特殊饮食(12.2%)和针灸(5.8%)。在CD中,疾病持续时间、最后一次随访日期、教育水平和既往手术是不坚持治疗的预测因素。两种疾病中,替代医学的使用都与年龄较小、教育水平较高和使用免疫抑制剂有关。此外,UC患者中女性和接受支持性精神/心理治疗的患者使用CAM更为常见。 结论:IBD患者中不坚持治疗和使用CAM很常见。在随访期间应特别关注探索已确定的预测因素,以提高治疗依从性并改善医患关系。
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