Charles C, Ninot G, Sultan S
Institut de Cancérologie Gustave-Roussy, 39 Rue Camille-Desmoulins, 94805 Villejuif, France.
Rev Mal Respir. 2011 May;28(5):626-35. doi: 10.1016/j.rmr.2010.11.003. Epub 2011 Apr 16.
Regular use of inhaled corticosteroids as preventive treatment of asthma is an integral part of management but remains inadequate among adults. Studying the perceptions of illness and treatment beliefs is one way to understand the patient's adherence to medication.
A systematic review was performed of empirical studies in adults published between 1999 and 2009, and indexed in the Pubmed, PsycInfo and Scopus databases. We investigated the associations between (1) perceptions of asthma and treatment beliefs and (2) adherence to inhaled corticosteroids. Eighteen articles meet these criteria.
Perception of the chronicity of asthma and its consequences on daily life, as well as the concept that it is necessary to continue treatment in the absence of symptoms, are associated with better adherence. On the contrary, fear of side effects and the belief that treatment is ineffective in controlling symptoms, are associated with poor adherence.
Patients' perceptions of asthma and inhaled corticosteroids are predictors of adherence to treatment. The identification and discussion of these issues is an essential part of building a therapeutic relationship that facilitates adherence.
定期使用吸入性糖皮质激素作为哮喘的预防性治疗是管理的一个组成部分,但在成年人中仍不充分。研究疾病认知和治疗观念是理解患者药物依从性的一种方式。
对1999年至2009年间发表的、在Pubmed、PsycInfo和Scopus数据库中索引的关于成年人的实证研究进行了系统综述。我们调查了(1)哮喘认知和治疗观念与(2)吸入性糖皮质激素依从性之间的关联。18篇文章符合这些标准。
对哮喘慢性病程及其对日常生活影响的认知,以及在无症状时仍需继续治疗的观念,与更好的依从性相关。相反,对副作用的恐惧以及认为治疗对控制症状无效的观念,与依从性差相关。
患者对哮喘和吸入性糖皮质激素的认知是治疗依从性的预测因素。识别和讨论这些问题是建立促进依从性的治疗关系的重要组成部分。