Faculty of Social & Political Sciences, University of Peloponnese, Corinth, Greece.
School of Nursing, University of Thessaly Greece.
Asian Pac J Cancer Prev. 2021 Jun 1;22(6):1891-1898. doi: 10.31557/APJCP.2021.22.6.1891.
Adherence to treatment can be defined as the degree to which a patient's behavior is consonant with medical or health advice he or she receive as part of his treatment regimen. The aim of this study was: 1) to measure the rate of treatment adherence to among patients with lung cancer from the prospect of both patients and physicians, 2) to measure the degree of concordance between the two prospect, and 3) to identify factors related to adherence for both prospect (patients and physicians).
A total of 250 patients were included in this study. Information about socio-economic characteristics, depressive and anxiety symptoms (Hospital Anxiety and Depression scale), nicotine dependence (Fagerstrom scale), barriers to accessing care, and the level of treatment adherence was collected through interview. Physicians were enquired about disease and treatment variables as well as patients' level of adherence.
From the patient perspective, only 1.2% of patients displayed poor adherence; whereas the corresponding percentage among physicians was 12.4%. The concordance between the two was low: 0.244. The correlation of measurements made on the same individual was found to be equal to 0.14. Barriers to accessing medication (O.R.=2.82, 95% C.I.: 1.01-8.09) was the only risk factor when adherence was self-rated; barriers to accessing medication (O.R.=2.45, 95% C.I.: 1.03-5.86), education equal to 12 years (O.R.=0.33, 95% C.I.: 0.13-0.82) or higher than 12 years (O.R.=0.28, 95% C.I.: 0.08-0.96), nicotine dependence (O.R.=1.41, 95% C.I. 1.17-1.69) and HADS anxiety score (O.R.=1.15, 95% C.I. 1.03-1.30) were the predictors in physicians' rating.
Differences in rating adherence may underpin communication gaps between patients and physicians. Systemic determinants of poor adherence should not be overlooked. A concerted effort by researchers, physicians and policy makers in defining as well as communicating adherence, while removing its barriers should be made.
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治疗依从性可定义为患者的行为与他/她作为治疗方案一部分所接受的医学或健康建议的一致性程度。本研究的目的是：1）从患者和医生两个角度衡量肺癌患者的治疗依从率，2）衡量两个角度之间的一致性程度，3）确定与两个角度相关的因素（患者和医生）。
本研究共纳入 250 名患者。通过访谈收集了社会经济特征、抑郁和焦虑症状（医院焦虑和抑郁量表）、尼古丁依赖（Fagerstrom 量表）、获得护理的障碍以及治疗依从性水平等信息。医生询问了疾病和治疗变量以及患者的依从性水平。
从患者的角度来看，只有 1.2%的患者表现出较差的依从性，而医生的相应比例为 12.4%。两者之间的一致性程度较低，为 0.244。对同一个体进行的测量的相关性被发现等于 0.14。当自我评估时，药物获取障碍（OR=2.82，95%CI：1.01-8.09）是唯一的危险因素；药物获取障碍（OR=2.45，95%CI：1.03-5.86）、教育程度等于 12 年（OR=0.33，95%CI：0.13-0.82）或高于 12 年（OR=0.28，95%CI：0.08-0.96）、尼古丁依赖（OR=1.41，95%CI：1.17-1.69）和 HADS 焦虑评分（OR=1.15，95%CI：1.03-1.30）是医生评估的预测因素。
对依从性的评价差异可能反映了患者和医生之间沟通的差距。不应忽视导致依从性差的系统性决定因素。研究人员、医生和政策制定者应共同努力，在定义和沟通依从性的同时，消除其障碍。
