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预测美国普通人群中大量成年人自我报告的药物低依从性的因素:一项横断面研究。

Factors predicting self-reported medication low adherence in a large sample of adults in the US general population: a cross-sectional study.

作者信息

Feehan Michael, Morrison Margaux A, Tak Casey, Morisky Donald E, DeAngelis Margaret M, Munger Mark A

机构信息

The Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA.

The Moran Eye Center, Department of Ophthalmology and Visual Sciences, Moran Eye Centre, University of Utah School of Medicine, Salt Lake City, Utah, USA.

出版信息

BMJ Open. 2017 Jun 23;7(6):e014435. doi: 10.1136/bmjopen-2016-014435.

Abstract

OBJECTIVES

The study objective was to determine the level and correlates of self-reported medication low adherence in the US general population.

SETTING

A 30 min cross-sectional online survey was conducted with a national sample of adults.

PARTICIPANTS

9202 adults (aged 18+) who had filled at least three or more prescriptions at a community pharmacy in the past 12 months.

PRIMARY AND SECONDARY OUTCOME MEASURES

Self-reported medication adherence was measured with the 8-item Morisky Medication Adherence Scale.

RESULTS

Low adherence was reported by 42.0%, 29.4% had medium adherence and 28.6% had high adherence. Low adherence was significantly associated with: lower age, being of Hispanic origin or African-American, having difficulty with healthcare, medication or transportation costs, needing the support of others to access primary care, health limiting activity, using multiple providers, infrequent visits to primary care providers and visiting an emergency department >3 times in last 12 months.

CONCLUSIONS

A very high level of low medication adherence is seen in the general population, particularly for ethnic minorities, those who use multiple healthcare providers and those who experience barriers to access for regular primary care. As clinical, patient education and counselling, and healthcare policy initiatives are directed to tracking the problem of low medication adherence, these should be priority populations for research and interventions.

摘要

目的

本研究旨在确定美国普通人群中自我报告的药物低依从性水平及其相关因素。

设置

对全国成年样本进行了一项30分钟的横断面在线调查。

参与者

9202名成年人(年龄在18岁及以上),他们在过去12个月内在社区药房至少开具了三种或更多处方。

主要和次要结局指标

使用8项Morisky药物依从性量表测量自我报告的药物依从性。

结果

42.0%的人报告低依从性,29.4%的人有中等依从性,28.6%的人有高依从性。低依从性与以下因素显著相关:年龄较小、西班牙裔或非裔美国人、在医疗保健、药物或交通费用方面有困难、需要他人支持才能获得初级保健、健康限制活动、使用多个医疗服务提供者、不经常拜访初级保健提供者以及在过去12个月内急诊就诊超过3次。

结论

普通人群中药物低依从性水平非常高,尤其是少数民族、使用多个医疗服务提供者的人群以及在获得常规初级保健方面存在障碍的人群。由于临床、患者教育和咨询以及医疗保健政策举措都旨在追踪药物低依从性问题,这些人群应成为研究和干预的重点对象。

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