Baudrant-Boga M, Lehmann A, Allenet B
Pôle pharmacie, pharmacie Vercors, CHU de Grenoble et UFR de pharmacie, université Joseph-Fourier, Grenoble cedex, France.
Ann Pharm Fr. 2012 Jan;70(1):15-25. doi: 10.1016/j.pharma.2011.10.003. Epub 2011 Nov 25.
Patient compliance is a dynamic behaviour, which varies in time and in shape. The impact of poor adherence is medical (loss of immediate benefits and/or long-term) and economic (direct and indirect costs). Adhering and remaining engaged in the daily drug treatment appear to be a challenge for the chronic patient. In this context, we propose as a first step, to describe the evolution of the wording around adherence. This evolution is underlying the paradigm shifts behind this concept and opens new areas for action. Based on this new angle of view that represents the patient's adherence with its drug therapy, we detail the various factors influencing medication adherence categorized into five dimensions: illness, medication, demographic and socio-economic, patient and/or patient support and care system. The impact of these factors is described and explanatory models underlying explicited. Understanding of the issues underlying adherence to drug treatment will help consider further personalized interventions, multi-faceted response to the multiplicity of influencing factors.
患者依从性是一种动态行为，其在时间和形式上都会有所变化。依从性差会产生医疗方面的影响（即时益处和/或长期益处的丧失）以及经济方面的影响（直接和间接成本）。坚持并持续参与日常药物治疗对慢性病患者而言似乎是一项挑战。在此背景下，我们提议第一步先描述围绕依从性的措辞演变情况。这种演变是该概念背后范式转变的基础，并开辟了新的行动领域。基于代表患者对药物治疗依从性的这一新视角，我们详细阐述了影响药物治疗依从性的各种因素，这些因素可分为五个维度：疾病、药物、人口统计学和社会经济因素、患者及/或患者支持与护理系统。描述了这些因素的影响，并明确了其背后的解释模型。理解药物治疗依从性背后的问题将有助于考虑进一步的个性化干预措施，以多方面应对多种影响因素。
