Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Endocrinology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Eur J Public Health. 2019 Jun 1;29(3):419-424. doi: 10.1093/eurpub/cky259.
Medication adherence is a complex area of behaviour. Little is known about what influences chronic patients to take their medicines. This study has aimed to compare and contrast the health-related beliefs, experiences and types of behaviour typical among patients who have at least one chronic condition and are following a pharmacological treatment in accordance with their level of medication adherence.
A questionnaire-based cross-sectional study, consisting of socio-demographic data, the 4-item Morisky-Green scale and 37 statements about health beliefs, perceptions and experiences, was conducted at different levels of healthcare (primary and tertiary settings).
A total of 577 questionnaires were analyzed. Respondents had a mean age of 64 and took an average of 4.6 drugs. Optimal adherence was reported by 58.6% of respondents. Bivariate analysis showed adherent subjects were older, took more medications, were in better spirits and had greater confidence and information regarding their treatment. Multivariate analysis found older age and the statements 'My doctor periodically reviews my treatment' and 'I am motivated to continue with the treatment' to be significantly related to medication adherence, while 'I make variations when taking medication depending on how I feel' was significant for medication non-adherence.
Medication non-adherence is common among chronic patients. Patient-centred approaches should be implemented in daily clinical practice as patient health beliefs, experiences and conduct influence medication-taking. Motivational interviewing might improve medication adherence in permitting emotional state managing and increasing educational skills, patient motivation and confidence between patients and healthcare providers.
用药依从性是一种复杂的行为。对于哪些因素影响慢性患者服药，人们知之甚少。本研究旨在比较和对比具有至少一种慢性疾病并按照药物治疗方案服药的患者在健康相关信念、经验和行为类型方面的差异，这些患者的药物依从性水平不同。
采用基于问卷的横断面研究，包括社会人口统计学数据、4 项 Morisky-Green 量表和 37 项关于健康信念、认知和经验的陈述，在不同的医疗保健水平（初级和三级医疗机构）进行。
共分析了 577 份问卷。受访者的平均年龄为 64 岁，平均服用 4.6 种药物。58.6%的受访者报告了最佳的依从性。单变量分析显示，依从性较好的患者年龄较大，服用的药物较多，精神状态较好，对治疗的信心和信息也较多。多变量分析发现，年龄较大以及“我的医生定期检查我的治疗”和“我有动力继续治疗”这两个陈述与药物依从性显著相关，而“我根据自己的感觉调整药物剂量”则与药物不依从性显著相关。
慢性患者中普遍存在药物不依从的情况。在日常临床实践中应实施以患者为中心的方法，因为患者的健康信念、经验和行为会影响药物的使用。动机性访谈可以通过管理情绪状态、提高教育技能、增强患者的动机和信心来改善药物依从性，从而促进患者和医疗保健提供者之间的沟通。
