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患者对药物的期望——一项综述与定性综合分析

Patients' expectations of medicines--a review and qualitative synthesis.

作者信息

Dohnhammar Ulrica, Reeve Joanne, Walley Tom

机构信息

Department of Health Services Research, University of Liverpool, Liverpool, UK.

出版信息

Health Expect. 2016 Apr;19(2):179-93. doi: 10.1111/hex.12345. Epub 2015 Feb 1.

Abstract

BACKGROUND

An increasing part of prescribing of medicines is done for the purpose of managing risk for disease and is motivated by clinical and economic benefit on a long-term, population level. This makes benefit from medicines less tangible for individuals. Sociology of pharmaceuticals includes personal and social perspectives in the study of how medicines are used. We use two characterizations of patients' expectations of medicines to start forming a description of how individuals conceptualize benefits from risk management medicines.

SEARCH STRATEGY AND SYNTHESIS

We reviewed the literature on patients' expectations with a focus on the influences on expectations regarding medicines prescribed for long-term conditions. Searches in Medline and Scopus identified 20 studies for inclusion, describing qualitative aspects of beliefs, views, thoughts and expectations regarding medicines.

RESULTS

A qualitative synthesis using a constant comparative thematic analysis identified four themes describing influences on expectations: a need to achieve a specific outcome; the development of experiences and evaluation over time; negative values such as dependency and social stigma; and personalized meaning of the necessity and usefulness of medicines.

CONCLUSIONS

The findings in this synthesis resonate with previous research into expectations of medicines for prevention and treatment of different conditions. However, a gap in the knowledge regarding patients' conceptualization of future benefits with medicines is identified. The study highlights suggestions for further empirical work to develop a deeper understanding of the role of patients' expectations in prescribing for long-term risk management.

摘要

背景

越来越多的药物处方是为了管理疾病风险,其动机是长期的临床和经济效益,且是基于人群层面的考量。这使得药物对个体的益处变得不那么明显。药物社会学在研究药物使用方式时纳入了个人和社会视角。我们利用患者对药物的两种期望特征,开始构建对个体如何理解风险管理药物益处的描述。

检索策略与综合分析

我们回顾了关于患者期望的文献,重点关注对长期疾病所开药物期望的影响因素。在Medline和Scopus数据库中进行检索,确定了20项纳入研究,这些研究描述了对药物的信念、观点、想法和期望的定性方面。

结果

采用持续比较主题分析法进行的定性综合分析确定了四个描述期望影响因素的主题:实现特定结果的需求;随着时间推移经验的积累和评估;诸如依赖和社会污名等负面因素;以及药物必要性和有用性的个性化意义。

结论

本综合分析的结果与先前关于预防和治疗不同疾病药物期望的研究结果一致。然而,在患者对药物未来益处的概念化方面存在知识空白。该研究突出了进一步实证研究的建议,以更深入地理解患者期望在长期风险管理处方中的作用。

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