Liguori Yuji, Murase Katsuhito, Hamamura Misako
a Japan Strategy & Business Development , Takeda Pharmaceutical Company Limited , Tokyo , Japan.
Curr Med Res Opin. 2016 Sep;32(9):1539-45. doi: 10.1080/03007995.2016.1189408. Epub 2016 May 19.
Non-adherence to prescribed medication presents a barrier to effective treatment. In order to find improved ways of tackling non-adherence, it is important to understand the perspective of both patients and physicians.
A web-based survey study was performed to obtain the views and opinions of patients receiving medical treatment for hypertension or diabetes mellitus in Japan, and physicians treating such patients, on adherence to medication.
Forty-four percent of both physicians and patients placed great importance on medication adherence, but 11% of patients considered it of low importance. Overall, 85% of patients reported taking their medication correctly. Patients missed a mean of 4.8 or 5.4 daily doses per 30 day prescription based on patient and physician estimates, respectively. Both patients (64%) and physicians (23%) considered the main reason patients forgot to take their medication was that they "inadvertently forgot". Only 1% of physicians said they do not specifically check for residual drugs, but 46% of patients said they do not report missed doses to their doctor. Measures taken by physicians to reduce residual drugs included use of single packs (64%) and reductions in administration frequency (55%); 63% adjusted prescriptions to take account of any remaining drugs. Only 4% of physicians were satisfied with the effectiveness of measures to reduce non-adherence, whereas 59% of patients felt they managed to successfully perform measures to avoid forgetting to take drugs.
The study questionnaires were newly developed and did not incorporate validated instruments to assess adherence.
Similar proportions of physicians and patients consider medication adherence to be important, but their opinions about measures used to improve adherence differ to some extent. Importantly, almost half of patients do not tell their doctor about missed doses.
不遵医嘱服药是有效治疗的一大障碍。为了找到改善不遵医嘱问题的方法，了解患者和医生双方的观点很重要。
开展了一项基于网络的调查研究，以获取日本接受高血压或糖尿病治疗的患者以及治疗此类患者的医生对服药依从性的看法和意见。
44%的医生和患者都非常重视服药依从性，但11%的患者认为其重要性较低。总体而言，85%的患者报告称能正确服药。根据患者和医生的估计，患者每30天的处方平均分别漏服4.8剂或5.4剂。患者（64%）和医生（23%）都认为患者忘记服药的主要原因是“不小心忘记了”。只有1%的医生表示他们不会专门检查剩余药物，但46%的患者表示他们不会向医生报告漏服剂量。医生采取的减少剩余药物的措施包括使用单剂量包装（64%）和减少给药频率（55%）；63%的医生会调整处方以考虑剩余药物。只有当4%的医生对减少不遵医嘱措施的有效性感到满意，而59%的患者认为他们成功地采取了措施来避免忘记服药。
研究问卷是新开发的，没有纳入经过验证的评估依从性的工具。
医生和患者中认为服药依从性重要的比例相似，但他们对用于改善依从性的措施的看法在一定程度上有所不同。重要的是，几乎一半的患者不会向医生告知漏服剂量的情况。
