Liekens S, Hulshagen L, Dethier M, Laekeman G, Foulon V
KU Leuven, Department of Pharmaceutical & Pharmacological Sciences Onderwijs & Navorsing 2, boîte 521, Herestraat 49, 3000 Leuven.
KLAV-LTD, Ilgatlaan 5, 3500 Hasselt.
J Pharm Belg. 2013 Dec(4):18-27.
Medication adherence in chronic conditions such as asthma, type 2 diabetes, heart failure, HIV and cancer appears to be a frequent problem. However, the literature on adherence in patients who use inhaled corticosteroids (ICS), oral hypoglycemic agents, drugs for heart failure, antiretrovirals or oral chemotherapy, contains little or no relevant data for Belgium. In the context of a Master thesis in Pharmaceutical care at KU Leuven, a quantitative study was performed to determine the prevalence of adherence to chronic medication in Belgium. This retrospective, cross-sectional study used a database containing refill data of a regional pharmacists' association (KLAV). Out of the 603 pharmacies affiliated with this association, all 50 pharmacies where HIV medication was delivered, were selected. Dispensing data from the selected pharmacies were collected from 01/07/2008 to 31/12/2009 for five pathologies, i.e.; asthma, type 2 diabetes, heart failure, HIV and cancer. Adherence (TT) was calculated with the Medication Refill Adherence (MRA) method. In order to determine whether there were associations between age, gender, drug class and adherence, Chi-square tests were used. Compared with the other patients, cancer patients were the most adherent in taking their drugs (median adherence rate = 88%). In addition, this was the only group in which the median adherence rate was above the set limit of 80%. The patients who were prescribed inhaled corticosteroids were the least adherent (median adherence rate = 38%). More than 50% of patients with asthma/COPD, heart failure and diabetes were classified as "under-users". Furthermore, the results showed a significant association within asthma patients between gender and adherence. In asthma, type 2 diabetes, heart failure and HIV patients there was a significant relationship between age and adherence and drug class and adherence. As the current study has some limitations, the results should be handled with caution. Nevertheless, the current study shows that also in Belgium there is a problem with medication adherence in chronic conditions, especially in asthma patients.
在哮喘、2型糖尿病、心力衰竭、艾滋病和癌症等慢性病中,药物依从性似乎是一个常见问题。然而,关于使用吸入性糖皮质激素(ICS)、口服降糖药、心力衰竭药物、抗逆转录病毒药物或口服化疗药物的患者的依从性文献,几乎没有或完全没有比利时的相关数据。在鲁汶大学药学保健硕士论文的背景下,进行了一项定量研究,以确定比利时慢性药物治疗的依从性患病率。这项回顾性横断面研究使用了一个包含地区药剂师协会(KLAV)再填充数据的数据库。在该协会附属的603家药店中,选择了所有提供艾滋病药物的50家药店。从2008年7月1日至2009年12月31日收集所选药店的配药数据,涉及五种病症,即哮喘、2型糖尿病、心力衰竭、艾滋病和癌症。使用药物再填充依从性(MRA)方法计算依从性(TT)。为了确定年龄、性别、药物类别和依从性之间是否存在关联,使用了卡方检验。与其他患者相比,癌症患者服药的依从性最高(中位依从率 = 88%)。此外,这是唯一一组中位依从率高于设定的80%限制的群体。使用吸入性糖皮质激素的患者依从性最低(中位依从率 = 38%)。超过50%的哮喘/慢性阻塞性肺疾病、心力衰竭和糖尿病患者被归类为“用药不足者”。此外,结果显示哮喘患者的性别与依从性之间存在显著关联。在哮喘、2型糖尿病、心力衰竭和艾滋病患者中,年龄与依从性以及药物类别与依从性之间存在显著关系。由于当前研究存在一些局限性,结果应谨慎对待。尽管如此,当前研究表明,在比利时,慢性病的药物依从性也存在问题,尤其是在哮喘患者中。