Koyanagi Kaori, Kubota Toshio, Kobayashi Daisuke, Kihara Taro, Yoshida Takeo, Miisho Takamasa, Miura Tomoko, Sakamoto Yoshiko, Takaki Junichi, Seo Takashi, Shimazoe Takao
Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu UniversityFukuoka, Japan; Fukuoka City Pharmaceutical AssociationFukuoka, Japan.
Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan.
Front Pharmacol. 2016 Jul 20;7:212. doi: 10.3389/fphar.2016.00212. eCollection 2016.
Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence.
The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs).
A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR). We analyzed prescription factors contributing to non-adherence based on the PRR.
Prescription information for 1207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas.
Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.
药物依从性对慢性病患者的健康结局有重要影响。然而，在日本，很少有研究来确定与药物不依从相关的因素。
本研究的目的是通过调查患者特征、所有处方以及口服抗糖尿病药物（OAD）的处方，来确定与药物不依从相关的处方因素。
在参与剩余药物合理使用的社区药房，对关于给药方案实施情况的处方数据进行回顾性横断面调查。我们评估了最初开具的药物量以及使用剩余药物后的减量，然后计算处方减量率（PRR）。我们基于PRR分析导致不依从的处方因素。
审查了1207例患者的处方信息，发现患者对58%的处方存在不依从情况。缺乏药物自付费用、同时服用的药物较少以及药物不是单剂量包装与不依从相关。在1207例患者中，包括2项糖尿病处方和452种OAD制剂。47%的处方和29%的制剂存在不依从情况。给药频率较高和餐前给药与不依从相关。在OAD中，α-葡萄糖苷酶抑制剂和双胍类药物的依从性低于磺脲类药物。
与患者特征、一般药物处方和OAD处方相关的几个因素与不依从有关。在日本，需要进一步考虑以提高药物依从性。医疗保健提供者应对本研究确定的有相关因素的患者的依从性进行更仔细的监测。
