Department of Family Medicine, Medical University of Lodz, 60, Narutowicza St., 90-136, Lodz, Poland.
Department of Biopharmacy, Medical University of Lodz, Lodz, Poland.
BMC Pediatr. 2021 Jan 6;21(1):16. doi: 10.1186/s12887-020-02477-z.
Due to high prevalence, non-adherence to prescribed treatment seriously undermines the effectiveness of evidence-based therapies in paediatric patients. In order to change this negative scenario, physicians need to be aware of adherence problem, as well as of possible solutions. Unfortunately, full potential of adherence-targeting interventions is still underused in Poland. Therefore, the aim of this study was to assess the knowledge, attitudes and behaviours toward non-adherence in Polish paediatricians.
An anonymous cross-sectional nationwide survey was conducted in the convenience sample of Polish doctors providing care to paediatric patients. The survey focused on the prevalence of non-adherence, its causes, and interventions employed. Primary studied parameter was perceived prevalence of non-adherence in paediatric patients. Reporting of this study adheres to STROBE guidelines.
One thousand and thirty-three responses were eligible for analysis. Vast majority of respondents were female (85.9%), most of them worked in primary care (90.6%). The respondents represented all 16 Polish Voivodeships, with the biggest number coming from the Mazowieckie Voivodeship (n = 144, 13.9%). Survey participants believed that on average 28.9% of paediatric patients were non-adherent to medication. More than half of the respondents (n = 548, 53.0%) were convinced that their own patients were more adherent than average. Duration of the professional practice strongly correlated with a lower perceived prevalence of non-adherence. Professionals with more than 40 years of practice believed that the percentage of non-adherent patients was <=20% particularly often (OR = 3.82 (95% CI 2.11-6.93) versus those up to 10 years in practice). Out of all respondents, they were also most often convinced that their own patients were more adherent than the general population (P < 0.01). Consequently, they underestimated the need for training in this area.
Physicians taking care of Polish paediatric patients underestimated the prevalence of medication non-adherence and believed that this was a problem of other doctors. This optimistic bias was particularly pronounced in older doctors. These results identify important barriers toward improving patient adherence that are worth addressing in the pre- and post-graduate education of Polish physicians. They also put some light over the challenges that educational activities in this area may face.
由于患病率高，不遵守规定的治疗方案严重削弱了循证疗法在儿科患者中的效果。为了改变这种负面局面，医生需要意识到依从性问题以及可能的解决方案。不幸的是，波兰仍未充分利用针对依从性的干预措施的全部潜力。因此，本研究旨在评估波兰儿科医生对不依从性的认识、态度和行为。
采用便利抽样方法，对提供儿科患者护理的波兰医生进行了一项匿名横断面全国性调查。该调查重点关注不依从性的流行率、原因和采用的干预措施。主要研究参数是儿科患者不依从性的感知流行率。本研究报告符合 STROBE 指南。
1033 份回复符合分析条件。绝大多数受访者为女性（85.9%），其中大多数在初级保健机构工作（90.6%）。受访者代表波兰所有 16 个省，其中来自马佐夫舍省的受访者最多（n=144，13.9%）。调查参与者认为，平均有 28.9%的儿科患者不遵守药物治疗方案。超过一半的受访者（n=548，53.0%）确信自己的患者比平均水平更依从。专业实践的年限与感知到的不依从率较低呈强烈相关。从业超过 40 年的专业人员特别频繁地认为不依从患者的比例<=20%（OR=3.82（95%CI 2.11-6.93），而从业时间不超过 10 年的则认为这一比例为 3.82（95%CI 2.11-6.93））。在所有受访者中，他们也最常认为自己的患者比一般人群更依从（P<0.01）。因此，他们低估了在这方面培训的需求。
照顾波兰儿科患者的医生低估了药物治疗不依从的流行率，并认为这是其他医生的问题。这种乐观偏见在年长的医生中尤为明显。这些结果确定了在波兰医生的研究生教育中值得解决的改善患者依从性的重要障碍。它们还揭示了该领域教育活动可能面临的挑战。
