González-Bueno Javier, Calvo-Cidoncha Elena, Nieto-Martín María Dolores, Pérez-Guerrero Concepción, Ollero-Baturone Manuel, Santos-Ramos Bernardo
Pharmacy Department, Consorci Hospitalari de Vic, Barcelona, Spain.
Pharmacy Department, Hospital Clínic, Barcelona, Spain.
Eur J Hosp Pharm. 2019 Jan;26(1):39-45. doi: 10.1136/ejhpharm-2017-001240. Epub 2017 Sep 27.
To select interventions aimed at improving medication adherence in patients with multimorbidity by means of a standardised methodology.
A modified Delphi methodology was used to reach consensus. Interventions that had demonstrated their efficacy in improving medication adherence in patients with multimorbidity or in similar populations were identified from a literature search of several databases (PubMed, EMBASE, the Cochrane Library, Center for Reviews and Dissemination, and Web of Science). 11 experts in medication adherence and/or chronic disease scored the selected interventions for appropriateness according to three criteria: strength of the evidence that supported each intervention, usefulness in patients with multimorbidity, and feasibility of implementation in clinical practice. The final set of interventions was selected according to appropriateness and agreement based on the Delphi methodology.
566 articles were retrieved in the literature search. Nine systematic reviews were included. 33 interventions were initially selected for evaluation by the panellists. Consensus after two Delphi rounds was reached on 16 interventions. Five interventions were categorized as educational, six as behavioural and five were related to other aspects of interest.
The interventions selected following a comprehensive and standardized methodology, could be used to improve medication adherence in patients with multimorbidity.
通过标准化方法选择旨在提高多病共存患者药物治疗依从性的干预措施。
采用改良的德尔菲法达成共识。通过检索多个数据库（PubMed、EMBASE、Cochrane图书馆、综述与传播中心及科学网），确定在提高多病共存患者或类似人群药物治疗依从性方面已证明其有效性的干预措施。11位药物治疗依从性和/或慢性病领域的专家根据三个标准对所选干预措施的适宜性进行评分：支持各干预措施的证据强度、对多病共存患者的有用性以及在临床实践中的实施可行性。根据德尔菲法，依据适宜性和一致性选出最终的干预措施集。
文献检索共检索到566篇文章。纳入9篇系统评价。专家小组最初选择33项干预措施进行评估。经过两轮德尔菲法，就16项干预措施达成共识。5项干预措施归类为教育类，6项为行为类，5项与其他感兴趣的方面相关。
通过全面且标准化方法选择的干预措施可用于提高多病共存患者的药物治疗依从性。
