Bender Bruce G
Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA,
Curr Allergy Asthma Rep. 2015 Mar;15(3):10. doi: 10.1007/s11882-014-0507-8.
Patient nonadherence significantly burdens the treatment of allergic rhinitis (AR). Fewer than half of prescribed doses of intranasal corticosteroid medication are taken. The challenges for immunotherapies are even greater. While sustained treatment for 3 to 5 years is required for full benefit, most patients receiving immunotherapy, either subcutaneous or sublingual, stop treatment within the first year. Although research into interventions to improve AR adherence is lacking, lessons learned from adherence interventions in other chronic health conditions can be applied to AR. Two well-established, overriding models of care-the chronic care model and patient-centered care-can improve adherence. The patient-centered care model includes important lessons for allergy providers in their daily practice, including understanding and targeting modifiable barriers to adherence. Additionally, recent studies have begun to leverage health information and communication technologies to reach out to patients and promote adherence, extending patient-centered interventions initiated by providers during office visits.
患者不依从性给过敏性鼻炎(AR)的治疗带来了沉重负担。鼻用皮质类固醇药物的处方剂量服用率不到一半。免疫疗法面临的挑战更大。虽然需要持续治疗3至5年才能获得充分益处,但大多数接受皮下或舌下免疫疗法的患者在第一年就停止了治疗。尽管缺乏关于改善AR依从性干预措施的研究,但从其他慢性健康状况的依从性干预措施中吸取的经验教训可应用于AR。两种成熟的、首要的护理模式——慢性病护理模式和以患者为中心的护理模式——可以提高依从性。以患者为中心的护理模式为过敏症医护人员的日常实践提供了重要经验教训,包括理解并针对依从性方面可改变的障碍。此外,最近的研究已开始利用健康信息和通信技术与患者取得联系并促进依从性,扩展了医护人员在门诊就诊期间发起的以患者为中心的干预措施。