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一项教育干预措施对提高社区药房配药时患者抗生素依从性的影响。

The effect of an educational intervention to improve patient antibiotic adherence during dispensing in a community pharmacy.

作者信息

Muñoz Elena Bernabé, Dorado Macarena Flores, Guerrero José Espejo, Martínez Fernando Martínez

机构信息

Profesora, Instituto de Enseñanza Secundaria Ingeniero de la Cierva, Murcia, Spain.

Doctora en Farmacia, Técnico de Investigación, Fundación Pública Andaluza para la Gestión de Investigación en Salud de Sevilla, Miembro del Grupo de Investigación en Atención Farmacéutica (CTS-131), Sevilla, Spain.

出版信息

Aten Primaria. 2014 Aug-Sep;46(7):367-75. doi: 10.1016/j.aprim.2013.12.003. Epub 2014 Feb 26.

Abstract

OBJECTIVE

To assess the effectiveness of an educational intervention on antibiotic adherence and patient-reported resolution of symptoms.

DESIGN

A controlled experimental study with systematic assignment to groups.

SETTING

A pharmacy in Murcia. Participants were patients who came to the pharmacy with a prescription for antibiotics. Intervention provided information on treatment characteristics (duration, dose and method of use) and correct compliance. A control group received routine care. Main variables "treatment adherence" and "perceived health" were evaluated one week after dispensation by telephone interview.

RESULTS

A total of 126 patients completed the study, 62 in the Control Group (CG) and 64 in the Intervention Group (IG). There were no differences between the groups in baseline characteristics, including the level of knowledge before the intervention. At the end of the study, treatment adherence in the CG was 48.4% (CI: 36.4-60.6), compared with 67.2% (CI: 55.0-77.4) in the IG. The difference of 18.8% was statistically significant (p=0.033; 95% CI=15.8-34.6). Non-compliance through missing more than one dose was 81.2% in the CG versus 38.1% in the IG, which is a statistically significant difference of 43.1% (p=0.001; 95% CI=16.4-63.1%). No significant differences were found in patient-perceived health. Logistic regression showed as predictor of adherence, the medication knowledge and the coincidence between duration of treatment indicated by physician and duration of treatment written in the prescription.

CONCLUSIONS

An educational intervention during antibiotic dispensation improves treatment adherence versus routine care.

摘要

目的

评估一项教育干预措施对抗生素依从性及患者报告的症状缓解情况的有效性。

设计

一项进行系统分组的对照实验研究。

地点

穆尔西亚的一家药店。参与者为前来该药店开具抗生素处方的患者。干预措施提供了有关治疗特征(疗程、剂量和使用方法)及正确依从性的信息。对照组接受常规护理。主要变量“治疗依从性”和“感知健康状况”在配药一周后通过电话访谈进行评估。

结果

共有126名患者完成了研究,对照组(CG)62名,干预组(IG)64名。两组在基线特征方面无差异,包括干预前的知识水平。研究结束时,CG组的治疗依从率为48.4%(置信区间:36.4 - 60.6),而IG组为67.2%(置信区间:55.0 - 77.4)。18.8%的差异具有统计学意义(p = 0.033;95%置信区间 = 15.8 - 34.6)。CG组因漏服超过一剂导致的不依从率为81.2%,而IG组为38.1%,43.1%的差异具有统计学意义(p = 0.001;95%置信区间 = 16.4 - 63.1%)。在患者感知健康状况方面未发现显著差异。逻辑回归显示,依从性的预测因素为用药知识以及医生指示的治疗疗程与处方中书写的治疗疗程的一致性。

结论

抗生素配药期间的教育干预相较于常规护理可提高治疗依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df1/6983631/46d70bc422c6/fx1.jpg

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