Laufs U, Böhm M, Kroemer H K, Schüssel K, Griese N, Schulz M
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar.
Dtsch Med Wochenschr. 2011 Aug;136(31-32):1616-21. doi: 10.1055/s-0031-1281566. Epub 2011 Aug 1.
Up to 50 % of patients with chronic diseases do not take their medication regularly. Poor adherence to drug therapy is associated with higher morbidity and mortality. A selective literature search using the terms adherence, compliance, concordance, persistence, medication management, and pharmaceutical care was performed. Evidence for improving adherence has been provided for the following principles: individual counselling of patients and care givers, medication management including simplifying dosing and use of combination tablets as well as the use of individual unit doses, e. g. blister cards. The effectiveness has only been shown for the duration of the interventions. The improvement of medication adherence represents an area of research with high impact on outcomes and cost. Measures to improve adherence may be as important as the development of novel therapies. However, prospective clinical evaluations with clinical endpoints are missing especially for the German health care system in order to develop recommendations for clinical practice. Joint efforts of physicians and pharmacists are needed.
高达50%的慢性病患者不按时服药。药物治疗依从性差与更高的发病率和死亡率相关。使用依从性、顺应性、一致性、持续性、药物管理和药学服务等术语进行了选择性文献检索。以下原则已提供了改善依从性的证据：对患者和护理人员进行个体化咨询，药物管理包括简化给药方式和使用复方片剂以及使用单剂量包装，如泡罩包装。仅在干预期间显示出有效性。改善药物依从性是一个对结果和成本有重大影响的研究领域。改善依从性的措施可能与开发新疗法同样重要。然而，尤其是对于德国医疗保健系统，缺乏以临床终点为指标的前瞻性临床评估，以便为临床实践制定建议。需要医生和药剂师共同努力。
