痛风患者尿酸降低治疗的依从率：一项系统评价和荟萃分析。
Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis.
作者信息
Yin Rulan, Li Lin, Zhang Guo, Cui Yafei, Zhang Lijuan, Zhang Qiuxiang, Fu Ting, Cao Haixia, Li Liren, Gu Zhifeng
机构信息
Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China.
Emergency and critical care medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
BMJ Open. 2018 Apr 10;8(4):e017542. doi: 10.1136/bmjopen-2017-017542.
INTRODUCTION
Reported adherence to urate-lowering therapy (ULT) in gout varies widely (17%-83.5%). Variability may partly be due to different adherence measurement methods. This review aimed to quantify ULT adherence in adult patients with gout.
METHODS
This analysis examined studies in PubMed, Web of Science, CNKI Scholar and WanFang databases from inception to January 2017. Papers were selected by inclusion and exclusion criteria in the context. Random-effect meta-analysis estimated adherence.
RESULTS
22 studies were found by the inclusion criteria, which involved 1 37 699 patients with gout. Four ways to define adherence were reported. Meta-analysis revealed that the overall adherence rate was 47% (95% CI 42% to 52%, I=99.7%). Adherence rate to ULT was 42% (95% CI 37% to 47%, I=99.8%) for prescription claims, 71% (95% CI 63% to 79%) for pill count, 66% (95% CI 50% to 81%, I=86.3%) for self-report and 63% (95% CI 42% to 83%, I=82.9%) for interview, respectively. The influential factor on adherence rate was country of origin.
CONCLUSIONS
Among adult patients with gout, overall adherence rate to ULT was as low as 47%, which suggested that clinicians should pay more attention to medication adherence in patients with gout to effectively improve adherence to ULT.
引言
痛风患者中报告的降尿酸治疗（ULT）依从性差异很大（17%-83.5%）。这种差异可能部分归因于不同的依从性测量方法。本综述旨在量化成年痛风患者的ULT依从性。
方法
该分析检索了PubMed、科学网、中国知网和万方数据库中从建库至2017年1月的研究。根据纳入和排除标准筛选文献。采用随机效应荟萃分析估计依从性。
结果
纳入标准筛选出22项研究，涉及137699例痛风患者。报告了四种定义依从性的方法。荟萃分析显示，总体依从率为47%（95%CI 42%至52%，I=99.7%）。ULT的依从率，处方记录为42%（95%CI 37%至47%，I=99.8%），药丸计数为71%（95%CI 63%至79%），自我报告为66%（95%CI 50%至81%，I=86.3%），访谈为63%（95%CI 42%至83%，I=82.9%）。依从率的影响因素是原产国。
结论
在成年痛风患者中，ULT的总体依从率低至47%，这表明临床医生应更加关注痛风患者的药物依从性，以有效提高ULT的依从性。
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