Gagnon Monica D, Waltermaurer Eve, Martin Adam, Friedenson Colette, Gayle Eric, Hauser Diane L
From the Institute for Family Health, New York, NY (MDG, EG, DLH); the Benjamin Center, State University of New York, New Paltz (EW); the Institute for Advanced Medicine, Mount Sinai Health System, New York (AM); and the University of Pennsylvania School of Veterinary Medicine, Philadelphia (CF).
J Am Board Fam Med. 2017 May-Jun;30(3):331-336. doi: 10.3122/jabfm.2017.03.160129.
Nonadherence to medicines contributes to poor health outcomes, especially for patients with complicated medicine regimens. We examined adherence among patients at a family health center and the impact that barriers to getting medicines and negative beliefs about medicines have on adherence.
A survey was administered incorporating the 8-item Morisky Medication Adherence Scale, questions from the Beliefs about Medicine Questionnaire, and questions about patients' external barriers to getting medicines. Low adherence was examined by any external barrier and by higher negative beliefs, adjusting for patient characteristics.
The convenience sample of 343 participants is demographically representative of the larger population. Among these patients, 54% report low adherence, 51% have at least 1 barrier to adherence, and 52% report more negative than positive beliefs about medicines. When beliefs and barriers are examined together, patients with negative beliefs are 49% less likely to adhere than those with more positive beliefs, whereas barriers show no significant impact on adherence.
Negative beliefs about medicines are as prevalent in this population as external barriers to accessing medicines, but negative beliefs were more significantly associated with adherence than external barriers. Physicians should identify and address patients' negative beliefs about medicines to improve adherence rates.
不坚持服药会导致健康状况不佳，对于用药方案复杂的患者尤其如此。我们调查了一家家庭健康中心患者的服药依从性，以及获取药物的障碍和对药物的负面信念对依从性的影响。
进行了一项调查，其中纳入了8项的莫里西药物依从性量表、药物信念问卷中的问题，以及关于患者获取药物的外部障碍的问题。通过任何外部障碍和更高的负面信念来检查低依从性，并对患者特征进行调整。
343名参与者的便利样本在人口统计学上代表了更大的人群。在这些患者中，54%报告依从性低，51%至少有1个依从性障碍，52%报告对药物的负面信念多于正面信念。当同时考察信念和障碍时，有负面信念的患者比有更正面信念的患者坚持服药的可能性低49%，而障碍对依从性没有显著影响。
在这一人群中，对药物的负面信念与获取药物的外部障碍一样普遍，但负面信念与依从性的关联比外部障碍更显著。医生应识别并解决患者对药物的负面信念，以提高依从率。
