Witticke Diana, Seidling Hanna Marita, Klimm Hans-Dieter, Haefeli Walter Emil
Department of Clinical Pharmacology and Pharmacoepidemiology ; Cooperation Unit Clinical Pharmacy.
Patient Prefer Adherence. 2012;6:679-84. doi: 10.2147/PPA.S35950. Epub 2012 Sep 25.
The aim of this pilot study was to evaluate patients' self-reported attitudes towards medication-related factors known to impair adherence and to assess their prevalence in ambulatory care as an essential prerequisite to improve patient adherence.
We conducted a face-to-face interview with 110 primary care patients maintained on at least one drug. For each drug, the patient was asked to specify medication-related factors of interest, ie, dosage form, dosage interval, required relationship with food intake, and the planned time of day for intake, and to rate the individual relevance of each prevalent parameter on a three-point Likert scale (discriminating between prefer, neutral, and dislike).
Tablets with a once-daily dosage frequency were the most preferred dosage form, with a high prevalence in the ambulatory setting. Drug intake in the morning and evening were most preferred, and drug intake at noon was least preferred, but also had a low prevalence in contrast with drug intake independent of meals that was most preferred. Interestingly, only one quarter (26.4%) of all the patients were able to indicate clear preferences or dislikes.
When patients are asked to specify their preferences for relevant medication regimen characteristics, they clearly indicated regimens that have been associated with better adherence in earlier studies. Therefore, our results suggest that adaptation of drug regimens to individual preferences might be a promising strategy to improve adherence. Because the German health care system may differ from other systems in relevant aspects, our findings should be confirmed by evaluation of patient preferences in other health care systems. Once generalizability of the study results is shown, these findings could be a promising basis upon which to promote patient adherence right from the beginning of drug therapy.
本试点研究的目的是评估患者对已知会影响依从性的药物相关因素的自我报告态度,并评估这些因素在门诊护理中的发生率,这是提高患者依从性的重要前提。
我们对110名正在服用至少一种药物的初级护理患者进行了面对面访谈。对于每种药物,要求患者指明感兴趣的药物相关因素,即剂型、给药间隔、与食物摄入的必要关系以及计划的每日服药时间,并使用三点李克特量表(区分偏好、中立和不喜欢)对每个普遍存在的参数的个体相关性进行评分。
每日一次给药频率的片剂是最受青睐的剂型,在门诊环境中发生率很高。早晨和晚上服药最受青睐,中午服药最不受青睐,而且与最受青睐的与进餐无关的服药方式相比,中午服药的发生率也较低。有趣的是,所有患者中只有四分之一(26.4%)能够表明明确的偏好或不喜欢。
当要求患者指明他们对相关药物治疗方案特征的偏好时,他们明确指出了在早期研究中与更好的依从性相关的治疗方案。因此,我们的结果表明,使药物治疗方案适应个体偏好可能是提高依从性的一个有前景的策略。由于德国医疗保健系统在相关方面可能与其他系统不同,我们的研究结果应通过评估其他医疗保健系统中的患者偏好来加以证实。一旦研究结果的可推广性得到证明,这些发现可能成为从药物治疗开始就促进患者依从性的一个有前景的基础。