Wu Hongxia, Zhang Hui, Li Xin, Zhao Qian
Department of Respiratory and Critical Care Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China.
Psychol Health Med. 2023 Jul-Dec;28(7):1656-1670. doi: 10.1080/13548506.2022.2141277. Epub 2022 Nov 7.
The disease activity of Chronic obstructive pulmonary disease (COPD) patients is often measured, which can could be related to medication adherence. Yet, there is no systematic inventory of studies comparing adherents and non-adherent patients in terms of disease activity. The systematic review and meta-analysis aimed to reveal the effect of medication adherence on disease activity in patients with COPD. For the present meta-analysis, studies comparing medication adherence in adherents and non-adherent patients were screened and included. Results were expressed as mean difference (MD) and 95% CI. A total of eleven identified studies matched the inclusion criteria, reporting on a total of 6,346 COPD patients in the analysis. The number of exacerbations in COPD patients over a year was significantly lower in non-adherent patients than in adherent subjects (MD = 0.69, 95% CI [0.36,1.01], 0.0001). Similarly, a significant difference was observed between medication-adherent and non-adherent groups in FEV (MD = -166.47, 95% CI [-255.03, -77.92], = 0.0002). Interestingly, the results of the meta-analysis showed no significant difference between medication-adherent and non-adherent patients in SGRQ (MD = -0.85, 95% CI [-4.98, 3.27], = 0.68), CAT (MD = -0.83, 95% CI [-1.78, 0.13], = 0.09), and FEV% (MD = -3.33, 95% CI [-6.83, 0.17], = 0.06).The studies performed suggested that clinical medical staff should pay attention to the medication behavior of COPD patients and effectively improve the medication adherence of patients.
慢性阻塞性肺疾病(COPD)患者的疾病活动度常被测量,这可能与药物依从性有关。然而,目前尚无系统的研究综述来比较依从性和非依从性患者的疾病活动度。本系统综述和荟萃分析旨在揭示药物依从性对COPD患者疾病活动度的影响。对于本次荟萃分析,筛选并纳入了比较依从性和非依从性患者药物依从性的研究。结果以平均差(MD)和95%置信区间(CI)表示。共有11项符合纳入标准的研究,分析中总共纳入了6346例COPD患者。非依从性患者一年内COPD加重次数显著低于依从性患者(MD = 0.69,95% CI [0.36, 1.01],P = 0.0001)。同样,在第1秒用力呼气容积(FEV)方面,药物依从组和非依从组之间也观察到显著差异(MD = -166.47, 95% CI [-255.03, -77.92], P = 0.0002)。有趣的是,荟萃分析结果显示,在圣乔治呼吸问卷(SGRQ)(MD = -0.85, 95% CI [-4.98, 3.27], P = 0.68)、慢阻肺评估测试(CAT)(MD = -0.83, 95% CI [-1.78, 0.13], P = 0.09)和FEV占预计值百分比(FEV%)(MD = -3.33, 95% CI [-6.83, 0.17], P = 0.06)方面,药物依从性和非依从性患者之间无显著差异。这些研究表明,临床医务人员应关注COPD患者的用药行为,有效提高患者的药物依从性。