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糖尿病和血脂异常患者的药物依从性:相关因素和改善策略。

Medication adherence in patients with diabetes and dyslipidemia: associated factors and strategies for improvement.

机构信息

VA Eastern Colorado Health Care System, Cardiology Section, 111B, 1055 Clermont Street, Denver, CO, 80220, USA.

出版信息

Curr Cardiol Rep. 2013 Nov;15(11):418. doi: 10.1007/s11886-013-0418-7.

Abstract

Dyslipidemia and diabetes mellitus are commonly coincident, and together contribute to the development of atherosclerotic disease. Medication therapy is the mainstay of treatment for dyslipidemia. Optimal medication therapy for dyslipidemia in patients with diabetes reduces cardiovascular events but necessitates patients take multiple medications. As a result, sub-optimal adherence to medication therapy is common. Factors contributing to medication non-adherence in patients taking multiple medications are complex and can be grouped into patient-, social and economic-, medication therapy-, and health provider and health system-related factors. Strategies aimed at improving medication adherence may target the patient, health care providers, or health systems. Recent data suggest medication non-adherence contributes to racial health disparities. In addition, health literacy, cost-related medication non-adherence, and patient beliefs regarding medication therapy have all been recently described as factors affecting medication adherence. Data from within the last year support an important role for regular contact between patients and health care providers to effectively address these factors. Cost-related barriers to medication adherence have recently been addressed through examination of health system approaches to decreasing cost-related non-adherence.

摘要

血脂异常和糖尿病通常同时存在,并且共同导致动脉粥样硬化疾病的发生。药物治疗是血脂异常治疗的主要方法。对于糖尿病患者的血脂异常,最佳药物治疗可降低心血管事件的发生,但需要患者服用多种药物。因此,药物治疗的依从性往往不理想。导致服用多种药物的患者药物依从性差的因素很复杂,可以分为患者、社会和经济、药物治疗以及医疗保健提供者和卫生系统相关因素。旨在提高药物依从性的策略可能针对患者、医疗保健提供者或卫生系统。最近的数据表明,药物不依从与种族健康差异有关。此外,最近还描述了药物治疗相关的健康素养、与费用相关的药物不依从以及患者对药物治疗的信念等因素会影响药物的依从性。过去一年的数据支持患者与医疗保健提供者之间定期联系,以有效解决这些因素的重要作用。最近通过研究卫生系统降低与费用相关的不依从的方法,解决了与药物依从性相关的费用障碍。

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