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在常规护理中医生和药房工作人员的支持活动对患者他汀类药物依从性的影响。

Impact of physician' and pharmacy staff supporting activities in usual care on patients' statin adherence.

作者信息

Huiskes Victor Johan Bernard, Vriezekolk Johanna Everdina, van den Ende Cornelia Helena Maria, van Dijk Liset, van den Bemt Bartholomeus Johannes Fredericus

机构信息

Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands.

Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.

出版信息

PLoS One. 2022 Feb 28;17(2):e0264555. doi: 10.1371/journal.pone.0264555. eCollection 2022.

Abstract

AIMS

Little is known about usual care by physicians and pharmacy teams to support adherence to statins and whether the extent of this care is associated with adherence to statins. Objective of the study was to examine the relationship between the extent of adherence supporting activities of healthcare practitioners (HCPs) and patients' adherence to statins.

METHODS

Cross-sectional study in 48 pharmacies and affiliated physicians' practices, between September 3, 2014 and March 20, 2015. Patients visiting the pharmacy with a statin prescription from participating prescribers were invited to participate. Usual care to support adherence was assessed among HCPs with the Quality of Standard Care questionnaire about usual care activities to support adherence. Adherence to statins was assessed among patients with the MARS-5 questionnaire. The association between the extent of HCPs' adherence supporting activities and patients' adherence was examined by means of multilevel regression analysis.

RESULTS

1,504 patients and 692 HCPs (209 physicians, 118 pharmacists and 365 pharmacy technicians) participated. No association was found between the extent of physicians' adherence supporting activities and patients' adherence to statins. The extent of adherence supporting activities by pharmacy teams in usual care was negatively associated with patients' adherence to statins (B coefficient -0.057 (95%CI: -0.112- -0.002).

CONCLUSIONS

This study suggests that there is no positive relationship between the extent of HCPs' adherence supporting activities in usual care and patients' adherence to statins. Other methods than questionnaires (e.g. electronic monitors (to assess adherence) and observations (to assess usual care) should be applied to confirm the results of this study.

摘要

目的

关于医生和药房团队为支持他汀类药物治疗依从性所提供的常规护理情况,以及这种护理的程度是否与他汀类药物治疗依从性相关,目前所知甚少。本研究的目的是探讨医疗从业者(HCPs)的依从性支持活动程度与患者他汀类药物治疗依从性之间的关系。

方法

2014年9月3日至2015年3月20日期间,在48家药房及其附属医生诊所开展横断面研究。邀请持参与研究的开处方医生开具的他汀类药物处方前来药房就诊的患者参与。通过关于支持依从性的常规护理活动的标准护理质量问卷,对HCPs提供的支持依从性的常规护理进行评估。通过MARS - 5问卷对患者的他汀类药物治疗依从性进行评估。采用多水平回归分析方法,研究HCPs的依从性支持活动程度与患者依从性之间的关联。

结果

1504名患者和692名HCPs(209名医生、118名药剂师和365名药房技术人员)参与了研究。未发现医生的依从性支持活动程度与患者他汀类药物治疗依从性之间存在关联。药房团队在常规护理中的依从性支持活动程度与患者他汀类药物治疗依从性呈负相关(B系数为 - 0.057(95%置信区间: - 0.112 - - 0.002))。

结论

本研究表明,HCPs在常规护理中的依从性支持活动程度与患者他汀类药物治疗依从性之间不存在正相关关系。应采用问卷调查以外的其他方法(如电子监测器(用于评估依从性)和观察(用于评估常规护理))来证实本研究结果。

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