Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7573, USA.
Res Social Adm Pharm. 2011 Dec;7(4):317-29. doi: 10.1016/j.sapharm.2010.11.001. Epub 2011 Jan 26.
There is an urgent need for research to improve the quality of medication use among those who require pharmacotherapy.
To describe how behavioral science theories can help to achieve this goal.
We begin by describing what a theory is and the functions that theories serve. We then provide 8 guiding principles that are crucial for investigators to understand if they are to use theory appropriately. We conclude by discussing the need for a new model of patient medication self-management that incorporates information concerning factors operating at all levels of the ecological framework, ranging from patient-level to societal-level factors.
The 8 guiding principles discussed are the following: (1) There is no single theory that is appropriate for guiding all medication use research; (2) Behavioral science theories are probabilistic, not deterministic; (3) When trying to influence a health behavior, the health behavior of interest must be defined precisely; (4) Many factors outside of patient control influence patient medication use; (5) Every patient is unique; (6) Patient motivation is a fundamental ingredient required to optimize medication use, especially when maintenance of long term behavior is the goal; (7) Health care providers can have a profound effect on patient medication use, and this effect can operate through several possible causal pathways; and (8) When planning an intervention to optimize medication use, it is important to develop a conceptual model that links intervention inputs to the ultimate outcomes that are desired.
Medication use can be influenced by a wide variety of factors acting at different levels of the ecological model. The quality of research on medication use could be improved by development of an ecological model specific to medication self-management.
迫切需要研究如何提高需要药物治疗的人群的药物使用质量。
描述行为科学理论如何有助于实现这一目标。
我们首先描述什么是理论以及理论的作用。然后，我们提供了 8 条指导原则，如果研究人员要正确使用理论，就必须了解这些原则。最后，我们讨论了需要一种新的患者药物自我管理模式的必要性，该模式纳入了在生态框架的所有层面（从患者层面到社会层面）运作的因素的信息。
讨论的 8 条指导原则如下：（1）没有一种单一的理论适用于指导所有药物使用研究；（2）行为科学理论是概率性的，而不是确定性的；（3）当试图影响一种健康行为时，必须精确地定义感兴趣的健康行为；（4）许多超出患者控制的因素影响患者的药物使用；（5）每个患者都是独特的；（6）患者的动机是优化药物使用所需的基本要素，尤其是当目标是维持长期行为时；（7）医疗保健提供者可以对患者的药物使用产生深远的影响，并且这种影响可以通过几种可能的因果途径发生；（8）在计划优化药物使用的干预措施时，重要的是要开发一个概念模型，将干预输入与期望的最终结果联系起来。
药物使用可以受到在生态模型不同层面上发挥作用的各种因素的影响。通过开发针对药物自我管理的特定生态模型，可以提高药物使用研究的质量。
