Nassar Razan I, Saini Bandana, Obeidat Nathir M, Atatreh Noor, Basheti Iman
MSc. Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
PhD. Professor in Clinical Pharmacy, College of Pharmacy, University of Sydney, Sydney, Australia.
Pharm Pract (Granada). 2022 Oct-Dec;20(4):2723. doi: 10.18549/PharmPract.2022.4.2723. Epub 2022 Oct 6.
Patients' adherence to medication can be assessed by several subjective or objective methods. The Global Initiative for Asthma (GINA) has recommended the use of both measures simultaneously.
To assess patients' adherence to medication using a subjective or an objective method separately, and via using a combination of both methods. As well as identifying the degree of agreement between the two methods.
Participants who met the study inclusion criteria completed the Adherence to Asthma Medication Questionnaire (AAMQ). A retrospective audit was conducted in order to extract pharmacy refill records for the previous twelve months. The patients' pharmacy refill records were expressed using the Medication Possession Ratio (MPR). Data were analyzed using the Statistical Package for Social Science. The degree of agreement was determined by Cohen's kappa coefficient (κ).
In terms of the difference in the ability of each method to identify non-adherent patients, a higher percentage of non-adherent patients were identified using the self-reported AAMQ (61.4%) compared to the pharmacy refill records (34.3%). When both methods, in combination, were used to assess adherence, the percentage of non-adherent patients was 80.0%, which is higher than each method when used separately. Twenty percent of the patients were considered adherent on both assessment methods, while 15.7% were considered non-adherent via both methods. Consequently, the AAMQ and pharmacy refill records agreed on 35.7% of the patients. The degree of agreement analysis showed a low correlation between the two methods.
The combination strategy resulted in a higher percentage of non-adherent patients, compared to using a subjective (the AAMQ) or an objective (the pharmacy refill records) method. The GINA guideline proposition may be supported by the present study's findings.
患者的用药依从性可通过多种主观或客观方法进行评估。全球哮喘防治创议（GINA）建议同时使用这两种方法。
分别使用主观或客观方法，以及同时使用两种方法来评估患者的用药依从性。同时确定两种方法之间的一致程度。
符合研究纳入标准的参与者完成了哮喘用药依从性问卷（AAMQ）。进行了一项回顾性审核，以提取前十二个月的药房配药记录。患者的药房配药记录用药物持有率（MPR）表示。使用社会科学统计软件包对数据进行分析。一致程度由科恩kappa系数（κ）确定。
就每种方法识别不依从患者的能力差异而言，与药房配药记录（34.3%）相比，使用自我报告的AAMQ识别出的不依从患者比例更高（61.4%）。当同时使用两种方法评估依从性时，不依从患者的比例为80.0%，高于单独使用每种方法时的比例。20%的患者在两种评估方法中均被视为依从，而15.7%的患者在两种方法中均被视为不依从。因此，AAMQ和药房配药记录对35.7%的患者评估结果一致。一致性分析表明两种方法之间的相关性较低。
与使用主观方法（AAMQ）或客观方法（药房配药记录）相比，联合策略识别出的不依从患者比例更高。本研究结果可能支持GINA指南的建议。
