Neiman Andrea B, Ruppar Todd, Ho Michael, Garber Larry, Weidle Paul J, Hong Yuling, George Mary G, Thorpe Phoebe G
MMWR Morb Mortal Wkly Rep. 2017 Nov 17;66(45):1248-1251. doi: 10.15585/mmwr.mm6645a2.
Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions (1). Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs (2). In the United States, 3.8 billion prescriptions are written annually (3). Approximately one in five new prescriptions are never filled, and among those filled, approximately 50% are taken incorrectly, particularly with regard to timing, dosage, frequency, and duration (4). Whereas rates of nonadherence across the United States have remained relatively stable, direct health care costs associated with nonadherence have grown to approximately $100-$300 billion of U.S. health care dollars spent annually (5,6). Improving medication adherence is a public health priority and could reduce the economic and health burdens of many diseases and chronic conditions (7).
坚持按医嘱服药与改善慢性病管理的临床结果以及降低慢性病死亡率相关(1)。相反,不坚持服药与更高的住院率、不理想的健康结果、发病率和死亡率增加以及医疗保健成本增加相关(2)。在美国,每年开出38亿张处方(3)。大约五分之一的新处方从未配药,在已配药的处方中,约50%的药服用不当,尤其是在服药时间、剂量、频率和疗程方面(4)。尽管美国各地的不坚持服药率一直相对稳定,但与不坚持服药相关的直接医疗保健成本已增至每年约1000亿至3000亿美元的美国医疗保健支出(5,6)。提高药物依从性是一项公共卫生优先事项,可减轻许多疾病和慢性病的经济和健康负担(7)。