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[你的患者服药了吗?临床实践中的依从性问题]

[Does your patient take his medicine? Compliance problems in clinical practice].

作者信息

Weber E, Kruse W

机构信息

Abteilung Klinische Pharmakologie der Medizinischen Universitätsklinik Heidelberg.

出版信息

Ther Umsch. 1990 Aug;47(8):629-34.

PMID:2218962
Abstract

There is convincing evidence from compliance research that deviations from the prescribed drug regimen is the rule rather than the exception. Demographic and psychosocial patient factors poorly correlate with non-compliance, whereas features of the disease, mechanisms of treatments, regimens and the patient physician interaction are particularly important determinants of patients' compliance behaviour. Non-compliance can not be predicted. There are problems in the assessment of non-compliance, more particularly of its clinical consequences. New microprocessor-based technology evaluated essential insight into patients' compliance behaviour and revealed different patterns of non-compliance. On one hand, the therapeutic outcome can be impaired by non-compliance, on the other hand, however, certain patterns of non-compliance appear to be appropriated from the patients' point of view. In medical practice it is important to consider non-compliance as essential impact on drug therapy and to promote the discussion of this issue with patients.

摘要

来自依从性研究的有力证据表明,偏离规定的药物治疗方案是常态而非例外。患者的人口统计学和社会心理因素与不依从性的相关性较弱,而疾病特征、治疗机制、治疗方案以及医患互动是患者依从行为的特别重要决定因素。不依从性无法预测。在评估不依从性,尤其是其临床后果方面存在问题。基于微处理器的新技术评估了对患者依从行为的基本洞察,并揭示了不同的不依从模式。一方面,不依从性会损害治疗效果,但另一方面,从患者角度来看,某些不依从模式似乎是合适的。在医疗实践中,将不依从性视为对药物治疗的重要影响并促进与患者就此问题进行讨论非常重要。

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