Russell Cynthia L, Cetingok Muammer, Hamburger Karen Q, Owens Sarah, Thompson Denise, Hathaway Donna, Winsett Rebecca P, Conn Vicki S, Madsen Richard, Sitler Lisa, Wakefield Mark R
Sinclair School of Nursing, University of Missouri, Columbia, MO 65203, USA.
Clin Nurs Res. 2010 May;19(2):95-112. doi: 10.1177/1054773810362039.
This project examined patterns, predictors, and outcomes of medication adherence in a convenience sample of 37 renal transplant recipients aged 55 years or older in a Mid-Southern U.S. facility using an exploratory, descriptive, longitudinal design. Electronic monitoring was conducted for 12 months using the Medication Event Monitoring System. An alarming 86% of the participants were nonadherent with medications. Four clusters of medication taking and timing patterns were identified with evening doses presenting particular challenges. Depression, self-efficacy, social support, and medication side effects did not predict medication adherence. There was no significant difference in medication adherence scores between those with and without infections. Medication adherence pattern data from electronic monitoring provides an opportunity for health care professionals to move away from blaming the patient by attempting to identify predictors for medication nonadherence. Medication dose taking and timing patterns could be explored with patients so that medication adherence interventions could target specific patient patterns.
本项目采用探索性、描述性纵向设计，对美国中南部一家医疗机构中37名年龄在55岁及以上的肾移植受者的便利样本进行了药物依从性的模式、预测因素和结果研究。使用药物事件监测系统进行了12个月的电子监测。令人震惊的是，86%的参与者未坚持服药。确定了四类服药和时间模式，其中晚间服药存在特别的挑战。抑郁、自我效能感、社会支持和药物副作用并不能预测药物依从性。有感染和无感染患者的药物依从性得分没有显著差异。电子监测的药物依从性模式数据为医护人员提供了一个机会，使其不再通过试图确定药物不依从的预测因素来指责患者。可以与患者探讨服药剂量和时间模式，以便药物依从性干预能够针对特定的患者模式。
