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鼻内镜鼻窦手术后慢性鼻-鼻窦炎患者药物治疗不依从性的患病率及相关因素

Prevalence and Associated Factors of Medication Non-Adherence in CRS Patients following Endoscopic Sinus Surgery.

作者信息

Gokani Shyam Ajay, Clark Allan, Javer Amin, Philpott Carl

机构信息

Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.

St Paul's Sinus Centre, Vancouver, BC V6Z 1Y6, Canada.

出版信息

J Clin Med. 2023 Aug 18;12(16):5381. doi: 10.3390/jcm12165381.

DOI:10.3390/jcm12165381
PMID:37629424
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10455742/
Abstract

This study aimed to evaluate factors that may predispose patients to not adhere to prescribed medication after endoscopic sinus surgery (ESS) and to compare SNOT-22 scores at 0-12 months post-operatively between adherent and non-adherent patients. CRS patients who underwent ESS between 2012 and 2016 were recruited to this retrospective cohort study. Adherence was assessed through a questionnaire and review of medical notes. Ninety-four participants were included (61% male, mean age 60). Of those, 66% did not adhere to their prescribed post-operative CRS medication timing or dosage. The most common reason for non-adherence was improvement of symptoms (17%), followed by deterioration of symptoms (11%) and side effects (10%). Post-operative SNOT-22 scores were lowest for non-intentionally non-adherent (NINA) participants with a mean of 10.5 [95% CI: 7.47-13.5], compared to 25.0 for intentionally non-adherent (INA) [95% CI: 17.6-32.4] and 17.7 for adherent patients [95% CI: 13.7-21.7], = 0.01. This study identifies that almost two-thirds of patients are not compliant with CRS medications after ESS. NINA participants reported lower post-operative SNOT-22 scores compared to INA and adherent participants. Future studies should focus on educating patients to continue with medications post-operatively despite an initial improvement in symptoms.

摘要

本研究旨在评估可能使患者在内镜鼻窦手术(ESS)后不坚持遵医嘱用药的因素,并比较术后0至12个月依从性和非依从性患者的鼻窦鼻相关生活质量量表(SNOT-22)评分。2012年至2016年间接受ESS的慢性鼻-鼻窦炎(CRS)患者被纳入这项回顾性队列研究。通过问卷调查和病历审查评估依从性。纳入94名参与者(61%为男性,平均年龄60岁)。其中,66%的患者未遵守术后CRS药物的服用时间或剂量。最常见的不依从原因是症状改善(17%),其次是症状恶化(11%)和副作用(10%)。非故意不依从(NINA)参与者术后SNOT-22评分最低,平均为10.5[95%置信区间:7.47-13.5],而故意不依从(INA)参与者为25.0[95%置信区间:17.6-32.4],依从性患者为17.7[95%置信区间:13.7-21.7],P = 0.01。本研究发现,几乎三分之二的患者在ESS后不遵守CRS药物治疗。与INA和依从性参与者相比,NINA参与者术后SNOT-22评分更低。未来的研究应侧重于教育患者,使其即使症状初步改善后仍在术后继续用药。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/2d91dc6b5dcd/jcm-12-05381-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/2d0ee565b79f/jcm-12-05381-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/e6fedf579118/jcm-12-05381-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/2d91dc6b5dcd/jcm-12-05381-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/2d0ee565b79f/jcm-12-05381-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/e6fedf579118/jcm-12-05381-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d74b/10455742/2d91dc6b5dcd/jcm-12-05381-g003.jpg

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本文引用的文献

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Patients Unmet Needs in Chronic Rhinosinusitis With Nasal Polyps Care: A Patient Advisory Board Statement of EUFOREA.慢性鼻-鼻窦炎伴鼻息肉患者未满足的需求:欧盟鼻科学与鼻过敏协会患者咨询委员会声明
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Clin Otolaryngol. 2021 Sep;46(5):1037-1043. doi: 10.1111/coa.13779. Epub 2021 Apr 22.
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Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery.
Ann Otol Rhinol Laryngol. 2020 Jul;129(7):707-714. doi: 10.1177/0003489420908291. Epub 2020 Feb 20.
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Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients.鼻腔内皮质类固醇和盐水:慢性鼻-鼻窦炎患者的使用和依从性。
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BMJ Open. 2019 Apr 23;9(4):e022644. doi: 10.1136/bmjopen-2018-022644.
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BMJ Open. 2018 Dec 19;8(12):e022643. doi: 10.1136/bmjopen-2018-022643.
8
Prevalence and associated factors of medication non-adherence in hematological-oncological patients in their home situation.血液肿瘤患者居家环境下药物不依从的流行状况及相关因素。
BMC Cancer. 2017 Nov 9;17(1):739. doi: 10.1186/s12885-017-3735-1.
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Medication and patient factors associated with adherence to pulmonary hypertension targeted therapies.与肺动脉高压靶向治疗依从性相关的药物和患者因素。
Pulm Circ. 2018 Jan-Mar;8(1):2045893217743616. doi: 10.1177/2045893217743616. Epub 2017 Nov 3.
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Evaluation of patient nasal saline irrigation practices following endoscopic sinus surgery.评估内镜鼻窦手术后患者进行鼻腔盐水冲洗的情况。
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