Department of Practice and Policy, School of Pharmacy, University College London, London WC1H 9JP, UK.
Department of Pharmacy and Pharmacology, University of Bath, Bath BA2 7AY, UK.
J Psychosom Res. 2019 Jul;122:54-68. doi: 10.1016/j.jpsychores.2019.03.184. Epub 2019 Mar 30.
Beliefs about medicines have been proposed as a strong determinant of medication adherence. It has been widely assessed using a Belief about Medicines Questionnaire (BMQ) for 20 years outside of China.
To investigate the use of the BMQ in China, and to evaluate the association between beliefs about medicines and medication adherence in the Chinese population.
A systematic review of studies published before February 2019 was performed in PubMed, EMBASE, PsycINFO, CNKI and WANFANG DATA. Any quantitative study that measured Chinese adults' medicine beliefs using BMQ translations was included. Random-effects meta-analysis with 95% confidence interval (CI) was used to test the correlations between BMQ-Specific components (Necessity Belief or Concerns or their differential scores) and medication adherence.
Fifty-eight eligible articles (n = 12,595) were identified with sample sizes ranged from 48 to 967. Three meta-analyses (n = 17, 18 & 19) containing total 22 studies were performed. Adherence was significantly correlated with necessity beliefs (pooled correlation coefficient = 0.32, 95% CI: 0.21, 0.43), concerns (-0.35, 95% CI: -0.42, -0.28), and the necessity-concerns differential score (0.25, 95% CI: 0.15, 0.36). There was significant heterogeneity between studies for necessity beliefs (I = 93%, p < .001), concerns (I = 83%, p < .001) and differential score (I = 95%, p < .001).
The BMQ appears to be a reliable tool for assessing medication beliefs in the Chinese population. Chinese people's specific medicine beliefs about medicines were significantly correlated with medication adherence. The Necessity-Concerns Framework was suggested as a useful conceptual model to explain Chinese patients' medication adherence.
药物信念被认为是影响药物依从性的重要决定因素。该理论自提出以来，已经在国外使用信念量表（Belief about Medicines Questionnaire，BMQ）进行了 20 多年的研究。
本研究旨在调查 BMQ 在国内的使用情况，并评估中国人群中药物信念与药物依从性之间的关系。
我们对发表于 2019 年 2 月前的文献进行了系统回顾，检索了 PubMed、EMBASE、PsycINFO、中国知网（CNKI）和万方数据知识服务平台。纳入使用 BMQ 对中国成年人的药物信念进行测量的定量研究。采用随机效应荟萃分析（meta-analysis）及 95%置信区间（confidence interval，CI）评估 BMQ 特定分量（必要性信念、顾虑或两者的差值）与药物依从性之间的相关性。
共纳入 58 篇文献（n=12595），样本量为 48 至 967 例。共进行了 3 项荟萃分析（n=17、18 和 19），包含 22 项研究。药物依从性与必要性信念（合并相关系数=0.32，95%CI：0.21，0.43）、顾虑（-0.35，95%CI：-0.42，-0.28）和必要性-顾虑差值得分（0.25，95%CI：0.15，0.36）显著相关。但必要性信念（I²=93%，p<0.001）、顾虑（I²=83%，p<0.001）和差值得分（I²=95%，p<0.001）的异质性较大。
BMQ 似乎是评估中国人群药物信念的可靠工具。中国人对药物的具体信念与药物依从性显著相关。必要性-顾虑框架被认为是解释中国患者药物依从性的有用概念模型。
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