Brandstetter Susanne, Finger Tamara, Fischer Wiebke, Brandl Magdalena, Böhmer Merle, Pfeifer Michael, Apfelbacher Christian
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051 Regensburg, Germany.
Department of Public Health Microbiology and Infectious Disease Epidemiology, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany.
Clin Transl Allergy. 2017 Nov 10;7:39. doi: 10.1186/s13601-017-0175-6. eCollection 2017.
Adherence to medication is crucial for achieving treatment control in chronic obstructive lung diseases. This study refers to the "necessity-concerns framework" and examines the associations between beliefs about medicines and self-reported medication adherence in people with chronic obstructive lung disease. 402 patients (196 with asthma, 206 with COPD) participated in the study and completed a questionnaire comprising the "Beliefs about Medicines-Questionnaire" (BMQ) and the "Medication Adherence Report Scale" (MARS). Multivariable logistic regression analyses with the BMQ-subscales as explanatory and the dichotomized MARS-score as dependent variable were computed for the asthma and the COPD sample, respectively, and adjusted for potentially confounding variables. 19% of asthma patients and 34% of COPD patients were completely adherent to their prescribed medication. While specific beliefs about the necessity of medicines were positively associated with medication adherence both in patients with asthma and with COPD, general beliefs about harm and overuse of medicines by doctors were negatively associated with medication adherence only among patients with asthma. The findings of this study suggest that patients' specific beliefs about the necessity of medicines represent an important modifiable target for improving patient-doctor consultations when prescribing medicines.
坚持用药对于慢性阻塞性肺疾病的治疗控制至关重要。本研究参考了“必要性 - 担忧框架”，并探讨了慢性阻塞性肺疾病患者对药物的信念与自我报告的用药依从性之间的关联。402名患者（196名哮喘患者，206名慢性阻塞性肺疾病患者）参与了该研究，并完成了一份包含“药物信念问卷”（BMQ）和“用药依从性报告量表”（MARS）的问卷。分别以哮喘和慢性阻塞性肺疾病样本的BMQ分量表为解释变量、二分的MARS分数为因变量进行多变量逻辑回归分析，并对潜在的混杂变量进行了校正。19%的哮喘患者和34%的慢性阻塞性肺疾病患者完全坚持服用处方药。虽然对药物必要性的特定信念在哮喘患者和慢性阻塞性肺疾病患者中均与用药依从性呈正相关，但关于医生用药有害和过度用药的一般信念仅在哮喘患者中与用药依从性呈负相关。本研究结果表明，患者对药物必要性的特定信念是改善开药时医患咨询的一个重要可改变目标。
