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血管炎患者药物不依从的预测因素。

Predictors of medication non-adherence for vasculitis patients.

机构信息

Division of Pharmaceutical Outcomes and Policy, CB#7573, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.

出版信息

Clin Rheumatol. 2013 May;32(5):649-57. doi: 10.1007/s10067-013-2164-z. Epub 2013 Jan 12.

Abstract

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n = 228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence subscale (α = 0.89). Variables that significantly correlated (p < 0.05) with non-adherence were included in a linear regression model to predict non-adherence. Younger age (r = -0.23, p < 0.001), female sex (r = 0.16, p < 0.05), experience of side effects (r = 0.15, p < 0.05), and more depressive symptoms (r = 0.22, p < 0.001) were associated with more medication non-adherence. In the regression model, younger age (β = -0.01, p = 0.01) and more depressive symptoms (β = 0.01 p = 0.02) predicted worse adherence. For six out of eight vasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression.

摘要

本文的主要目的是记录人口统计学、临床、方案相关、个体内部和人际因素是否预测血管炎患者的药物不依从性。次要目的是探讨依从性是否因药物类型而异,以及患者是否经历药物相关副作用。228 名血管炎患者完成了在线基线和 3 个月随访调查。人口统计学(年龄、性别、教育、种族、婚姻状况和保险状况)、临床(感知血管炎严重程度、疾病持续时间、血管炎类型和复发/缓解状态)、方案相关(副作用经历)、个体内部(抑郁症状)和人际(来自家人和朋友的与药物依从性相关的支持)因素在基线时进行测量。使用血管炎自我管理调查药物依从性量表(α=0.89)在随访时评估药物不依从性。与不依从性显著相关(p<0.05)的变量被纳入线性回归模型以预测不依从性。年龄较小(r=-0.23,p<0.001)、女性(r=0.16,p<0.05)、经历副作用(r=0.15,p<0.05)和更多抑郁症状(r=0.22,p<0.001)与更多的药物不依从性相关。在回归模型中,年龄较小(β=-0.01,p=0.01)和更多的抑郁症状(β=0.01,p=0.02)预测较差的依从性。对于八种血管炎药物类型中的六种,经历副作用的患者比没有经历副作用的患者依从性差。多种因素与血管炎患者的药物不依从性有关。提供者应与血管炎患者讨论药物依从性和药物相关副作用。提供者可能希望特别针对年轻患者和有临床抑郁迹象的患者。

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