Institute of Nursing Science, University of Basel, Switzerland.
Eur J Cardiovasc Nurs. 2011 Mar;10(1):14-21. doi: 10.1016/j.ejcnurse.2010.10.004. Epub 2010 Nov 20.
Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice.
To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions.
A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management.
Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence.
Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.
治疗心血管疾病往往需要服用多种药物，而心血管疾病患者常出现不遵医嘱的情况，这可能会产生严重的不良后果，因此应在日常实践中采取各种措施来提高患者的服药依从性。
评估心血管护士和相关健康专业人员采用何种策略来（1）评估患者对药物治疗方案的依从性，以及（2）通过教育/认知、咨询/行为和心理/情感干预来提高药物依从性。
2010 年 3 月，在日内瓦（瑞士）举行的第十届欧洲心脏病学会心血管护理和相关专业委员会年度春季会议上，向心血管护理和相关专业协会 10 届年会的参会者发放了一份包含 45 个问题的问卷，以评估卫生保健专业人员在日常临床实践中使用的依从性评估和干预策略。未直接进行临床护理的受访者被排除在外。采用描述性统计来描述关于药物依从性管理的实践模式。
在发放的 276 份问卷中，有 171 份（62%）被收回，其中 34 份（20%）因受访者不直接护理患者而被排除在外。在随访期间询问患者是否存在不遵医嘱的情况是最常报告的评估策略（56%）。最常使用的是教育/认知增强依从性的干预措施，其次是咨询/行为干预。较少使用心理/情感干预。最常使用的干预措施是提供阅读材料（66%），其次是在住院康复期间培训患者正确服药（48%）。略多于三分之二（69%）的人报告说使用了多种干预措施来提高患者的依从性。
在临床实践中，教育干预措施使用最广泛，尽管有证据表明，与行为干预相比，这些措施在提高药物依从性方面效果较差。
