Costa Elísio, Giardini Anna, Savin Magda, Menditto Enrica, Lehane Elaine, Laosa Olga, Pecorelli Sergio, Monaco Alessandro, Marengoni Alessandra
UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, Porto, Portugal.
Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Montescano (PV), Pavia, Italy.
Patient Prefer Adherence. 2015 Sep 14;9:1303-14. doi: 10.2147/PPA.S87551. eCollection 2015.
Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons.
药物依从性和持续性被公认为一个全球性的公共卫生问题，在慢性病管理中尤为重要。不遵守医疗计划影响各层面人群，但老年人受影响尤为严重，因为他们同时患有多种疾病，从而导致多重用药。慢性病管理需要持续的心理调适和行为重组。在文献中，针对不同临床情况描述了许多改善药物依从性的干预措施，然而，大多数干预措施似乎都未能实现其目标。此外，大多数与依从性改善相关的干预措施并未带来其他结果的改善。事实上，在过去几十年中，不依从程度一直没有变化。在这项工作中，我们回顾了为提高药物依从性而采用的最常见干预措施、测量的结果和取得的改善，以及现有依从性研究的主要局限性，特别关注老年人。
