Alvarez Payero M, Martínez López de Castro N, Ucha Samartín M, Martín Vila A, Vázquez López C, Piñeiro Corrales G
Servicio de Farmacia. Complejo Hospitalario Universitario de Vigo. Xerencia de Xestión Integrada de Vigo..
Farm Hosp. 2014 Jul 1;38(4):328-33. doi: 10.7399/fh.2014.38.4.7660.
Observational and retrospective study that included patients who were admitted to hospital with a secondary diagnosis of «Personal history of non-compliance with chronic medication» according to International Classification of Diseases, during 2012.
demographics; socioeconomic and clinical data; data related to the treatment; readmissions; hospital days; degree of adherence: ≤ 75% or severe non-adherence and > 75% or moderate non-adherence; type of non-adherence: non-persistence and noncompliance; hospitalization costs. Statistical analysis was performed.
Eighty-seven patients were admitted. These patients caused 104 episodes (16.3% were readmissions). 71.2% were men, and 51.5 (SD 17.8) years old. All patients had a chronic disease, adherence ≤ 75% (76%) and non-persistence (63.5%). Polypharmacy (47.1%) was not associated with non-adherence. Total stay was 1,527 days (mean stay was 14.7 (SD 14.0) days/episode): psychiatry 827 days (54.2%); cardiology 174 days (11.4%); critical unit 48 days (3.1%). Patients with a degree of adherence ≤ 75% had a mean stay/episode higher than those with a degree of adherence > 75%, without significant differences (p > 0.05, t-Student). Overall cost of hospitalization was Euros 594,230.8, with a mean cost/episode: Euros 5,713.6 (SD 5,039.5). Mean cost/episode for adherence ≤ 75% was higher than > 75%, Euros 6,275.8 (SD 5,526.2) vs Euros 3,895.6 (SD 2,371.3), (p < 0.05, t-Student).
The profile of this patient is fundamentally, a male psychiatric or chronic cardiac patient with a degree of adherence ≤ 75% due to abandoning domiciliary treatment. Admissions due to medication non-adherence are associated with an important depletion of economic resources in the hospital.
采用观察性回顾性研究，纳入2012年因国际疾病分类中二级诊断为“有不依从慢性药物治疗的个人史”而入院的患者。
人口统计学信息；社会经济和临床数据；与治疗相关的数据；再次入院情况；住院天数；依从程度：≤75%或严重不依从以及>75%或中度不依从；不依从类型：持续性中断和不遵从；住院费用。进行了统计分析。
共87例患者入院。这些患者引发了104次住院事件（16.3%为再次入院）。71.2%为男性，平均年龄51.5（标准差17.8）岁。所有患者均患有慢性病，依从程度≤75%（76%）且存在持续性中断（63.5%）。联合用药（47.1%）与不依从无关。总住院天数为1527天（平均每次住院14.7（标准差14.0）天）：精神科827天（54.2%）；心内科174天（11.4%）；重症监护病房48天（3.1%）。依从程度≤75%的患者平均每次住院天数高于依从程度>75%的患者，但无显著差异（p>0.05，t检验）。住院总费用为594,230.8欧元，平均每次住院费用为5,713.6欧元（标准差5,039.5）。依从程度≤75%的患者平均每次住院费用高于>75%的患者，分别为6,275.8欧元（标准差5,526.2）和3,895.6欧元（标准差2,371.3），（p<0.05，t检验）。
此类患者基本为男性精神科或慢性心脏病患者，因放弃居家治疗导致依从程度≤75%。因药物治疗不依从导致的入院与医院经济资源的大量消耗相关。
