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皮肤科治疗依从性干预研究及支持依从性的指导意见

Treatment Adherence Intervention Studies in Dermatology and Guidance on How to Support Adherence.

作者信息

Feldman Steven R, Vrijens Bernard, Gieler Uwe, Piaserico Stefano, Puig Lluís, van de Kerkhof Peter

机构信息

Wake Forest School of Medicine, Winston-Salem, USA.

WestRock Healthcare, Visé, Belgium.

出版信息

Am J Clin Dermatol. 2017 Apr;18(2):253-271. doi: 10.1007/s40257-017-0253-5.

Abstract

Adequate adherence to prescribed treatment regimens can help to break the cycle of treatment failure, disease progression and subsequent treatment escalation. Unfortunately, adherence in the treatment of skin disorders such as acne, atopic dermatitis/eczema and psoriasis is often inadequate. A review of the literature identified a number of studies that tested an intervention to improve adherence in dermatology, including the following: electronic messages and/or reminders; more frequent or 'extra' clinic visits; audio-visual and internet-based interventions; and patient support programmes and/or self-management, educational training programmes. While there is no one solution or action for improving adherence, some interventions were more successful than others. We provide practical guidance on how to support adherence based on aspects of the successful interventions identified and on our collective opinion and clinical practice experience. Holding patients accountable, providing a caring and supportive environment, raising awareness of poor adherence and helping patients build a solid medication-taking habit can help to improve adherence so that patients can experience maximal treatment benefits and desired clinical outcomes.

摘要

充分坚持规定的治疗方案有助于打破治疗失败、疾病进展及随后治疗升级的循环。不幸的是,在痤疮、特应性皮炎/湿疹和银屑病等皮肤病的治疗中,依从性往往不足。对文献的回顾发现了一些测试改善皮肤科依从性干预措施的研究,包括以下内容:电子信息和/或提醒;更频繁或“额外”的门诊就诊;视听和基于互联网的干预措施;以及患者支持计划和/或自我管理、教育培训计划。虽然没有一种解决方案或行动能提高依从性,但有些干预措施比其他措施更成功。我们根据已确定的成功干预措施的各个方面以及我们的集体意见和临床实践经验,提供关于如何支持依从性的实用指导。让患者负责,提供关爱和支持的环境,提高对依从性差的认识,并帮助患者养成稳固的服药习惯,有助于提高依从性,使患者能够获得最大的治疗益处和理想的临床结果。

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