Voils Corrine I, King Heather A, Neelon Brian, Hoyle Rick H, Reeve Bryce B, Maciejewski Matthew L, Yancy William S
Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA ; Department of Medicine, Duke University, NC, USA.
Health Services Research and Development, Durham Veterans Affairs Medical Center, NC, USA.
Patient Prefer Adherence. 2014 May 7;8:643-50. doi: 10.2147/PPA.S60715. eCollection 2014.
Little is known about weekly variability in medication nonadherence both between and within persons.
To characterize medication nonadherence across repeated, closely spaced occasions.
This prospective cohort study comprised four unannounced telephone assessment occasions, each separated by approximately 2 weeks. On each occasion, adult outpatients taking at least a single antihypertensive medication completed a measure of extent of, and reasons for, nonadherence.
Two hundred and sixty-one participants completed 871 (83%) of 1,044 occasions. Nonadherence was reported on 152 (17.5%) of 871 occasions by 93 (36%) of 261 participants. The most commonly endorsed reasons for nonadherence were forgetting (39.5%), being busy (23.7%), and traveling (19.7%). Among 219 participants completing at least three occasions, 50% of the variability in extent of nonadherence was a result of within-person fluctuations, and 50% was a result of between-person differences.
Interventions to reduce nonadherence should be informed by variability in the extent of nonadherence and specific reasons for nonadherence.
关于个体间和个体内药物治疗不依从性的每周变异性,人们了解甚少。
描述在重复且间隔紧密的情况下药物治疗不依从性的特征。
这项前瞻性队列研究包括四次未事先通知的电话评估,每次评估间隔约2周。每次评估时,服用至少一种抗高血压药物的成年门诊患者完成一项关于不依从程度及原因的测量。
261名参与者完成了1044次评估中的871次(83%)。261名参与者中有93名(36%)在871次评估中的152次(17.5%)报告了不依从情况。最常被认可的不依从原因是忘记(39.5%)、忙碌(23.7%)和出行(19.7%)。在完成至少三次评估的219名参与者中,不依从程度变异性的50%是个体内波动的结果,50%是个体间差异的结果。
减少不依从性的干预措施应依据不依从程度的变异性和不依从的具体原因来制定。