Department of Pharmacy, Sint Maartens Clinic, Nijmegen, The Netherlands.
Scand J Rheumatol. 2011 May;40(3):192-6. doi: 10.3109/03009742.2010.517214. Epub 2010 Oct 26.
We have developed an instrument that provides the physician structured information about medication use and patients' (non-)adherence. This study aimed to determine the effectiveness of this instrument on adherence and medication beliefs in outpatients with rheumatoid arthritis (RA).
In this within-subject controlled prospective cohort study, 50 outpatients were assessed during three consecutive visits to their rheumatologist. At these three points in time, patients' adherence, medication beliefs, satisfaction about information about medication, and physical functioning were measured using validated self-report questionnaires. An intervention was scheduled during the second visit. The intervention consisted of a written report informing the physician about medication use and adherence to medication for each patient. The effectiveness of the intervention was evaluated by comparing outcome measures at the third visit to the same measures assessed prior to the intervention.
At baseline, 30% of the patients (n = 50) were non-adherent. No significant changes in adherence were found between the first and second visit prior to the intervention. Adherence did not change after the intervention, compared to both of the adherence assessments prior to the intervention. Beliefs about medication, patients' satisfaction about information on medication, and physical functioning were also not significantly altered.
Supplying the rheumatologist a report with information about medication use and adherence did not change adherence or patients' beliefs about medication. Further research is necessary to ensure effective support for adherence for individual patients with RA.
我们开发了一种工具,为医生提供关于药物使用和患者(不)依从性的结构化信息。本研究旨在确定该工具对类风湿关节炎(RA)门诊患者依从性和药物信念的有效性。
在这项单组对照前瞻性队列研究中,在连续三次就诊期间评估了 50 名门诊患者。在这三个时间点,使用经过验证的自我报告问卷测量患者的依从性、药物信念、对药物信息的满意度和身体功能。在第二次就诊期间安排了一项干预措施。该干预措施包括一份书面报告,向医生提供每位患者的药物使用和药物依从性信息。通过将第三次就诊的评估结果与干预前的相同评估结果进行比较,评估干预的效果。
在基线时,有 30%的患者(n=50)不依从。在干预前的第一次和第二次就诊之间,依从性没有明显变化。与干预前的两次依从性评估相比,干预后依从性没有变化。药物信念、患者对药物信息的满意度和身体功能也没有显著改变。
向风湿病医生提供一份关于药物使用和依从性的报告并没有改变依从性或患者对药物的信念。需要进一步研究以确保为每个 RA 患者提供有效的依从性支持。