College of Pharmacy, University of Tennessee, Memphis 38163, USA.
J Am Pharm Assoc (2003). 2012;52(6):823-6. doi: 10.1331/JAPhA.2012.11088.
To provide a brief overview of the extent of medication nonadherence in the United States, its impact on patient health and health care costs, its causes, and possible strategies that health care practitioners can use to improve medication adherence.
Medication use and health care costs have increased dramatically during the previous decade in the United States. Adherence to medication therapy often is a critical aspect of medical treatment, particularly the treatment of chronic conditions such as diabetes and hypertension. Despite the importance of adherence, medication nonadherence is a serious problem, with the World Health Organization noting that the average nonadherence rate is 50% among those with chronic illnesses. Consequences of nonadherence include worsening condition, increased comorbid diseases, increased health care costs, and death. Nonadherence results from many causes; therefore, no easy solutions exist. The first step to addressing nonadherence is to recognize that collaboration must occur between health care practitioners and patients to increase adherence, with the goal of achieving optimal health outcomes.
The relationship between health care practitioners and patients and open, ongoing communication between the stakeholders are essential to combating medication nonadherence. Given their training and accessibility, pharmacists are well positioned to address nonadherence.
简要概述美国药物不依从的程度、其对患者健康和医疗保健成本的影响、原因以及医疗保健从业者可以用来提高药物依从性的可能策略。
在过去十年中，美国的药物使用和医疗保健成本大幅增加。药物治疗的依从性通常是医疗的一个关键方面，特别是治疗糖尿病和高血压等慢性病。尽管依从性很重要，但药物不依从是一个严重的问题，世界卫生组织指出，慢性病患者的平均不依从率为 50%。不依从的后果包括病情恶化、合并疾病增加、医疗保健成本增加和死亡。不依从有许多原因，因此没有简单的解决方案。解决不依从问题的第一步是认识到必须在医疗保健从业者和患者之间进行合作，以提高依从性，目标是实现最佳健康结果。
医疗保健从业者与患者之间的关系以及利益相关者之间持续的、开放的沟通对于对抗药物不依从至关重要。鉴于他们的培训和可及性，药剂师非常适合解决不依从问题。
