Department of Clinical Medicine, Miguel Hernandez University, 03550 San Juan, Spain.
Research Unit, Hospital General Universitario de Elda, 30600 Elda, Spain.
Int J Environ Res Public Health. 2022 Sep 23;19(19):12036. doi: 10.3390/ijerph191912036.
Medication adherence is directly associated with health outcomes. Adherence has been reviewed extensively; however, most studies provide a narrow scope of the problem, covering a specific disease or treatment. This project's objective was to identify risk factors for non-adherence in the fields of rheumatology, oncology, and cardiology as well as potential interventions to improve adherence and their association with the risk factors. The project was developed in three phases and carried out by a Steering Committee made up of experts from the fields of rheumatology, oncology, cardiology, general medicine, and hospital and community pharmacy. In phase 1, a bibliographic review was performed, and the articles/reviews were classified according to the authors' level of confidence in the results and their clinical relevance. In phase 2, 20 risk factors for non-adherence were identified from these articles/reviews and agreed upon in Steering Committee meetings. In phase 3, potential interventions for improving adherence were also identified and agreed upon. The results obtained show that adherence is a dynamic concept that can change throughout the course of the disease, the treatments, and other factors. Educational interventions are the most studied ones and have the highest level of confidence in the authors' opinion. Information and education are essential to improve adherence in all patients.
药物依从性与健康结果直接相关。依从性已经被广泛研究;然而,大多数研究提供了问题的狭窄范围,涵盖了特定的疾病或治疗。本项目的目的是确定风湿病、肿瘤学和心脏病学领域不依从的风险因素,以及改善依从性的潜在干预措施及其与风险因素的关联。该项目分三个阶段进行,由风湿病学、肿瘤学、心脏病学、普通医学以及医院和社区药学领域的专家组成指导委员会实施。在第一阶段,进行了文献综述,根据作者对结果的信心水平和临床相关性对文章/综述进行了分类。在第二阶段,从这些文章/综述中确定了 20 个不依从的风险因素,并在指导委员会会议上达成一致。在第三阶段,还确定了改善依从性的潜在干预措施,并达成了一致。研究结果表明,依从性是一个动态的概念,在疾病、治疗和其他因素的过程中可能会发生变化。教育干预是研究最多的,作者认为其可信度最高。信息和教育对于提高所有患者的依从性至关重要。