Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
Department of Pediatrics, Alpert Medical School, Brown University, Providence, RI, USA.
J Gen Intern Med. 2018 Feb;33(2):200-206. doi: 10.1007/s11606-017-4199-3.
Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, the patient's family and culture, interactions with healthcare providers, and the healthcare system itself. Because of its association with worse outcomes, poor medication adherence is considered a potential contributor to disparities in health outcomes observed for various conditions across racial and ethnic groups. While there are no simple answers, it is clear that patient, provider, cultural, historical, and healthcare system factors all play a role in patterns of medication use. Here, we provide an overview of the interface between culture and medication adherence for chronic conditions; discuss medication adherence in the context of observed health disparities; provide examples of cultural issues in medication adherence at the individual, family, and healthcare system/provider level; review potential interventions to address cultural issues in medication use; and provide recommendations for future work.
药物治疗的依从性取决于多种因素,包括患者的个体特征、患者的家庭和文化、与医疗保健提供者的互动以及医疗保健系统本身。由于与较差的结果相关,药物治疗的依从性差被认为是导致不同种族和族裔群体在各种疾病的健康结果中存在差异的潜在因素之一。尽管没有简单的答案,但显然患者、提供者、文化、历史和医疗保健系统因素都在药物使用模式中发挥了作用。在这里,我们提供了一个慢性疾病文化与药物治疗依从性之间关系的概述;讨论了在观察到的健康差异背景下的药物治疗依从性;提供了在个人、家庭和医疗保健系统/提供者层面上药物治疗依从性中的文化问题的例子;回顾了潜在的干预措施以解决药物使用中的文化问题;并为未来的工作提出了建议。