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巴西系统性红斑狼疮患者药物治疗依从性评估。

Evaluation of adherence to drug treatment in patients with systemic lupus erythematosus in Brazil.

机构信息

Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Rio de Janeiro, Brazil.

出版信息

Lupus. 2011 Mar;20(3):320-9. doi: 10.1177/0961203310383736. Epub 2010 Dec 23.

Abstract

The objectives of this study were to measure the prevalence of adherence to drug treatment and analyze associations with characteristics pertaining to the treatment, disease, health professionals and services, and socio-demographic issues in patients with systemic lupus erythematosus (SLE) in the city of Rio de Janeiro, Brazil. A sample of 246 women with SLE was analyzed. The data were collected through individual interviews and a review of patient charts. Adherence was estimated according to the Morisk criteria, and the associated factors were analyzed by hierarchical modeling. The percentage of patients classified as adherent to treatment was 31.7%. The reasons cited for non-adherence were: carelessness with drug administration times (52.43%), forgetfulness (38.21%), adverse drug reaction (13.8%), and interruption of treatment due to improvement in symptoms (7.72%). Factors associated with adherence were: behavior towards the presence of adverse drug reaction, hematological alterations, presence of mucocutaneous manifestations, legibility of the medical prescription, schooling, and family support. The study concludes that adherence to drug treatment in SLE is a complex and multifactorial phenomenon, and the results corroborate findings from studies conducted in developed countries. The hierarchical modeling proved to be a good alternative for evaluating adherence, since it allowed visualizing the various stages in the analysis.

摘要

本研究的目的是衡量巴西里约热内卢系统性红斑狼疮(SLE)患者药物治疗依从性的流行率,并分析与治疗、疾病、卫生专业人员和服务以及社会人口问题相关的特征。对 246 名患有 SLE 的女性进行了样本分析。数据通过个人访谈和患者病历回顾收集。根据 Morisk 标准评估依从性,采用分层建模分析相关因素。被归类为依从治疗的患者比例为 31.7%。不依从的原因包括:不注意药物给药时间(52.43%)、健忘(38.21%)、药物不良反应(13.8%)和症状改善导致中断治疗(7.72%)。与依从性相关的因素包括:对药物不良反应、血液学改变、黏膜皮肤表现、医嘱清晰度、教育程度和家庭支持的态度。研究结论是,SLE 患者的药物治疗依从性是一个复杂的多因素现象,研究结果与发达国家的研究结果一致。分层建模被证明是评估依从性的一个很好的选择,因为它可以直观地显示分析的各个阶段。

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