School of Human and Community Development, University of the Witwatersrand Johannesburg, South Africa.
Patient Educ Couns. 2011 Jun;83(3):310-8. doi: 10.1016/j.pec.2011.02.018. Epub 2011 Apr 7.
This study examined facilitators and barriers to adherence in four South African antiretroviral therapy (ART) clinic sites and explored context and communication factors in relation to the role of the pharmacist.
Data were collected from interviews and narratives of patients and health professionals around the issues of adherence and qualitatively analysed using principles of Thematic Content Analysis.
Findings confirm the complex interplay between illness, communication, sociocultural, economic, context and systemic issues. Analysis suggests adherence is multifaceted and reinforces the critical role of communication factors in achieving concordance between patient and pharmacist.
Successful treatment of HIV/AIDS depends on pharmacists and healthcare teams understanding contextual and interactional factors which play a role in adherence.
The findings reinforce the importance of embedding a patient-centred approach in the training and everyday practice of pharmacists. The value of qualitative methods in understanding barriers to adherence and the potential value of the cultural broker in intercultural settings is discussed. Some suggestions are made as to how adherence counselling can be made relevant and effective.
本研究考察了南非四个抗逆转录病毒疗法（ART）诊所中药物依从性的促进因素和障碍，并探讨了与药剂师角色相关的背景和沟通因素。
从患者和卫生专业人员的访谈和叙述中收集有关药物依从性的问题数据，并使用主题内容分析的原则进行定性分析。
研究结果证实了疾病、沟通、社会文化、经济、背景和系统问题之间的复杂相互作用。分析表明，药物依从性是多方面的，并强调了沟通因素在实现患者与药剂师之间一致性方面的关键作用。
成功治疗艾滋病毒/艾滋病取决于药剂师和医疗团队了解在药物依从性方面发挥作用的背景和相互作用因素。
研究结果强调了在药剂师的培训和日常实践中嵌入以患者为中心的方法的重要性。本文还讨论了定性方法在理解药物依从性障碍方面的价值，以及在跨文化环境中文化经纪人的潜在价值。针对如何使依从性咨询更相关和有效提出了一些建议。
