van Boven Job F M, Chavannes Niels H, van der Molen Thys, Rutten-van Mölken Maureen P M H, Postma Maarten J, Vegter Stefan
Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands.
Respir Med. 2014 Jan;108(1):103-13. doi: 10.1016/j.rmed.2013.08.044. Epub 2013 Sep 11.
Medication for Chronic Obstructive Pulmonary Disease (COPD) has shown to substantially reduce symptoms and slow progression of disease. However, non-adherence to medication is common and associated with worsened clinical and economic outcomes.
The objective of this study was to perform a systematic review of published literature to assess the impact of non-adherence to COPD medication on clinical and economic outcomes.
A search in PubMed and Web of Science databases was conducted of original studies published from database inception to 2012. Studies must report on the association between adherence to COPD medication and outcomes, published in English in peer-reviewed journals and full texts needed to be available.
Twelve full articles were included in the review. Most studies were retrospective database studies. Seven studies reported on the association between adherence and clinical outcomes, two on mortality, three on costs, four on quality of life and one on work productivity. Results indicated a clear association between adherence and both clinical and economic outcomes. Evidence from studies revealed increased hospitalizations, mortality, quality of life and loss of productivity among non-adherent patients.
This review revealed a clear association between non-adherence to COPD medication and worsened clinical and economic outcomes making non-adherent patients a priority for cost-effective interventions.
慢性阻塞性肺疾病（COPD）药物已显示可显著减轻症状并减缓疾病进展。然而，不遵医嘱用药的情况很常见，且与临床和经济结局恶化相关。
本研究的目的是对已发表的文献进行系统评价，以评估不遵医嘱使用COPD药物对临床和经济结局的影响。
在PubMed和科学网数据库中检索从数据库建立至2012年发表的原始研究。研究必须报告COPD药物依从性与结局之间的关联，发表于同行评审期刊的英文文章且需提供全文。
该评价纳入了12篇全文文章。大多数研究为回顾性数据库研究。7项研究报告了依从性与临床结局之间的关联，2项关于死亡率，3项关于成本，4项关于生活质量，1项关于工作效率。结果表明依从性与临床和经济结局之间存在明显关联。研究证据显示，不依从患者的住院率、死亡率、生活质量和生产力损失均有所增加。
该评价显示，不遵医嘱使用COPD药物与临床和经济结局恶化之间存在明显关联，这使得不依从患者成为具有成本效益干预措施的优先对象。
