J Am Pharm Assoc (2003). 2012;52(6):e199-204. doi: 10.1331/JAPhA.2012.12001.
To develop and conduct an initial field test of the Drug Adherence Work-up (DRAW) tool, which was developed to guide pharmacists when addressing nonadherence during medication therapy management (MTM) visits.
The field test was a prospective cohort study, in which seven trained pharmacists used DRAW to evaluate patients by asking about possible reasons for nonadherence during an MTM visit. Pharmacists were notified of potentially nonadherent patients identified through drug claims data analyzed by Outcomes Pharmaceutical Health Care. The pharmacists reported on use of DRAW in an MTM claim and provided opinions about DRAW via an online survey.
According to the online survey, pharmacists reported that DRAW helped them to improve the focus of their MTM services and address more adherence problems than their usual approach. They thought the tool was easy to use and well organized. Some commented that DRAW could be a useful tool for teaching pharmacists. The most common reasons reported for nonadherence were the presence of adverse effects (59.1%) or forgetting to take the medication (54.5%). More than three-fourths of patients (77.3%) indicated more than one reason for nonadherence.
A brief, comprehensive tool to evaluate medication nonadherence, such as DRAW, may help pharmacists address various reasons for medication nonadherence. Often nonadherence is multifaceted, which makes an inclusive tool like DRAW a useful approach; however further research is needed.
开发并初步实地测试药物依从性评估工具（DRAW），旨在指导药剂师在药物治疗管理（MTM）就诊时解决不依从问题。
该实地测试是一项前瞻性队列研究，其中 7 名经过培训的药剂师使用 DRAW 在 MTM 就诊期间询问可能导致不依从的原因，以此评估患者。药剂师会收到 OutcomesPharmaceuticalHealthCare 分析药物索赔数据后发现的潜在不依从患者的通知。药剂师会在 MTM 索赔中报告 DRAW 的使用情况，并通过在线调查提供对 DRAW 的意见。
根据在线调查，药剂师报告称 DRAW 有助于他们将 MTM 服务的重点提高，并解决比他们通常方法更多的依从性问题。他们认为该工具易于使用且组织良好。一些人评论说，DRAW 可以作为培训药剂师的有用工具。报告的不依从的最常见原因是存在不良反应（59.1%）或忘记服药（54.5%）。超过四分之三的患者（77.3%）表示存在不止一个不依从的原因。
简短、全面的评估药物不依从性的工具，如 DRAW，可以帮助药剂师解决药物不依从的各种原因。通常，不依从性是多方面的，这使得像 DRAW 这样的综合工具成为一种有用的方法；但是还需要进一步的研究。
