University of Padua, Italy.
Behav Med. 2010 Jul-Sep;36(3):100-7. doi: 10.1080/08964281003774935.
Poor adherence to prescribed medication is a well-known problem and continues to be a major challenge in all medical specialties. Unlike previous studies that have mainly focused on nonadherence behaviors in specific diseases, this study sought to examine socio-cognitive factors associated with nonadherence behavior in a sample of a general clinical population. A questionnaire investigating socio-demographic and cognitive factors and a telephone follow-up interview were administered to 84 patients recruited in a General Medicine Unit before their discharge. Half of the participants were informed about that follow-up procedure. One month after hospital discharge, 42% of uninformed patients reported nonadherence behaviors, as against 21% of informed patients. Middle-aged patients and short-term treatments were associated significantly more often with nonadherence. Among cognitive factors, patients' perceived risks and benefits of nonadherence, personal susceptibility to diseases, subjective health value, and reported memory failures were significantly associated with adherence. We conclude that a patient's perception may be more important than medication load, illness severity, and complexity of regimen in influencing medication adherence, and that a telephone call follow-up helps in monitoring medication adherence after hospital discharge.
遵医嘱服药的依从性差是一个众所周知的问题，在所有医学专业仍然是一个主要挑战。与之前主要关注特定疾病中非依从性行为的研究不同，本研究旨在调查一般临床人群样本中与非依从性行为相关的社会认知因素。在综合医学科招募的 84 名患者出院前，我们用一份调查问卷调查了社会人口学和认知因素，并对他们进行了电话随访。一半的参与者被告知了随访程序。出院后一个月，42%的未被告知的患者报告存在不遵医嘱行为，而告知的患者则为 21%。中年患者和短期治疗与不遵医嘱行为显著相关。在认知因素中，患者对不遵医嘱的感知风险和益处、对疾病的易感性、主观健康价值以及报告的记忆失败与依从性显著相关。我们的结论是，患者的认知可能比药物负荷、疾病严重程度和治疗方案的复杂性更能影响药物的依从性，而电话随访有助于监测出院后的药物依从性。
