Louis Elan D
GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Parkinsonism Relat Disord. 2015 Feb;21(2):138-41. doi: 10.1016/j.parkreldis.2014.12.001. Epub 2014 Dec 6.
There are numerous studies of medication adherence in a variety of chronic diseases including Parkinson's disease; however, there are no such studies in patients with essential tremor (ET). This study aimed to (1) present self-report data on medication adherence in ET cases, (2) examine the demographic and clinical factors that might be associated with lower medication adherence.
151 ET cases were enrolled in a clinical-epidemiological study at Columbia University. An 11-item medication adherence questionnaire, modeled after the Morisky medication adherence questionnaire, was administered.
Seventy-three (48.3%) of 151 cases were taking daily medication for ET. One-third (24/73; 32.9%) of cases reported that they sometimes forgot to take their medication, and 1 in 5 (15/73; 20.5%) reported missed doses within the past week. Most striking was that nearly 1 in 4 (17/73; 23.3%) reported that there were whole days in the past two weeks in which they had not taken their medication. A factor analysis revealed four factors that captured different aspects of non-adherence. Higher non-adherence was associated with more depressive symptoms, younger age, and less severe tremor but was not associated with type or number of ET medications.
Approximately one in four ET patients reported whole days in the past two weeks in which they had not taken their medication. It is possible that this relatively high rate of non-adherence could be a function of the poor therapeutic efficacy of the medications currently available to treat ET.
在包括帕金森病在内的多种慢性疾病中，有大量关于药物依从性的研究；然而，对于特发性震颤（ET）患者，尚无此类研究。本研究旨在（1）呈现ET患者药物依从性的自我报告数据，（2）探究可能与较低药物依从性相关的人口统计学和临床因素。
151例ET患者参与了哥伦比亚大学的一项临床流行病学研究。采用了一份以Morisky药物依从性问卷为蓝本的11项药物依从性问卷进行调查。
151例患者中有73例（48.3%）正在每日服用治疗ET的药物。其中三分之一（24/73；32.9%）的患者报告有时会忘记服药，五分之一（15/73；20.5%）的患者报告在过去一周内有漏服药物的情况。最令人惊讶的是，近四分之一（17/73；23.3%）的患者报告在过去两周中有一整天未服药。因素分析揭示了四个反映不依从不同方面的因素。较高的不依从性与更多的抑郁症状、更年轻的年龄以及较轻的震颤相关，但与ET药物的类型或数量无关。
约四分之一的ET患者报告在过去两周中有一整天未服药。目前用于治疗ET的药物治疗效果不佳，可能是导致这种相对较高不依从率的原因。
