Awwad Oriana, Akour Amal, Al-Muhaissen Suha, Morisky Donald
The University of Jordan, Amman, Jordan,
Int J Clin Pharm. 2015 Jun;37(3):504-10. doi: 10.1007/s11096-015-0086-3. Epub 2015 Feb 24.
Non-adherence to long-term therapy for chronic illnesses is considered the major reason why patients fail to reach their clinical goals, resulting in suboptimal health outcomes, death, and extra costs on the health care systems. Knowledge about the disease and prescription medications, an understanding of the reason the medication is needed, and good expectations or attitudes toward treatment, all contribute to a better medication-taking behavior and are associated with higher rates of adherence.
This study examines the relationship between knowledge and adherence of patients receiving long-term therapy for one or more chronic illnesses in Jordan.
The study was conducted in the out-patient clinics of two Jordanian hospitals (The University of Jordan Hospital and Jordan Hospital).
This was a cross-sectional study that included 902 patients. The correlation between patients' knowledge about their chronic medications and adherence was assessed. Effects of several sociodemographic characteristics were investigated in regard to knowledge and adherence.
Knowledge was assessed by a modified version of the McPherson index, and the Morisky Medication Adherence Scale was used to assess medication adherence.
A significant correlation was found between patients' knowledge and their adherence to medications (r = 0.357, p < 0.001). Most of the participants had low adherence. Younger age, higher education levels, high income, fewer medications and diseases were significant predictors of higher knowledge levels. Knowledgeable patients were found to be twice as likely to have moderate-to-high adherence as their unknowledgeable counterparts. Similarly, high income and higher education were associated with higher adherence scores.
Forgetfulness and aversion toward medications were the most common barriers to medication adherence. This implicates that clinicians and health care policy makers should direct their effort toward two main strategies to improve adherence increasing awareness and education of effective ways to remind patients about their medications.
不坚持慢性病的长期治疗被认为是患者无法实现临床目标的主要原因，这会导致健康结果不佳、死亡以及医疗保健系统的额外成本。对疾病和处方药的了解、对用药必要性的认识以及对治疗的良好期望或态度，都有助于形成更好的服药行为，并与更高的依从率相关。
本研究探讨约旦接受一种或多种慢性病长期治疗的患者的知识水平与依从性之间的关系。
该研究在约旦的两家医院（约旦大学医院和乔丹医院）的门诊进行。
这是一项横断面研究，纳入了902名患者。评估了患者对其慢性病药物的知识与依从性之间的相关性。研究了几种社会人口统计学特征对知识水平和依从性的影响。
通过修改后的麦克弗森指数评估知识水平，并使用莫利斯基药物依从性量表评估药物依从性。
发现患者的知识水平与其药物依从性之间存在显著相关性（r = 0.357，p < 0.001）。大多数参与者的依从性较低。年龄较小、教育水平较高、收入较高、药物和疾病较少是知识水平较高的显著预测因素。发现有知识的患者中度至高度依从的可能性是无知识患者的两倍。同样，高收入和高学历与更高的依从性得分相关。
遗忘和对药物的厌恶是药物依从性最常见的障碍。这意味着临床医生和医疗保健政策制定者应将努力方向指向两种主要策略以提高依从性，即提高对有效提醒患者服药方法的认识和教育。
