Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
Rush University Medical Center, Department of Neurological Sciences, Chicago, Illinois, United States.
Arq Neuropsiquiatr. 2024 Feb;82(2):1-8. doi: 10.1055/s-0044-1779608. Epub 2024 Feb 23.
Therapeutic adherence is a decisive issue on chronic disease management in patients requiring long-term pharmacotherapy, such as Parkinson's disease (PD). Although it is well known that socioeconomic factor is a barrier to medication adherence in many chronic diseases, its impacts on PD still need to be investigated.
Explore what and how socioeconomic factors impact medication adherence in people with PD.
We carried out a scoping review across three databases to identify studies exploring what and how socioeconomic factors impact medication adherence in people with PD considering eight attributes: 1. educational level, 2. disease-related knowledge, 3. income, 4. cost of medication, 5. drug subsidy (meaning presence of subsidies in the cost of medication), 6. employability, and 7. ethnicity (black, indigenous, immigrants).
Of the 399 identified studies (Embase = 294, Medline = 88, LILACS = 17), eight met inclusion criteria. We identified factors covering the eight attributes of socioeconomic impact, and all of them negatively impacted the medication adherence of people with PD. The most prevalent factor in the studies was low patient educational level (four studies), followed by costs of medications (three studies), income (three studies), and disease-related knowledge (three studies). Distinctly from most of the studies selected, one of them evidenced suboptimal adherence in individuals receiving the medication free of charge, and another one could not find correlation between suboptimal adherence and educational level.
Socioeconomic factors negatively impact medication adherence in PD patients. This review provides basis for developing patient and population-based interventions to improve adherence to treatment in PD.
在需要长期药物治疗的慢性病患者(如帕金森病)的管理中,治疗依从性是一个决定性的问题。尽管众所周知,社会经济因素是许多慢性病患者药物依从性的障碍,但仍需要研究其对帕金森病的影响。
探讨社会经济因素如何以及在何种程度上影响帕金森病患者的药物依从性。
我们在三个数据库中进行了范围综述,以确定研究帕金森病患者药物依从性的社会经济因素的研究,考虑了八个属性:1. 教育水平,2. 疾病相关知识,3. 收入,4. 药物费用,5. 药物补贴(指药物费用中的补贴),6. 就业能力,7. 种族(黑人、原住民、移民)。
在 399 项已确定的研究中(Embase=294 项,Medline=88 项,LILACS=17 项),有 8 项符合纳入标准。我们确定了涵盖社会经济影响的八个属性的因素,所有这些因素都对帕金森病患者的药物依从性产生了负面影响。研究中最常见的因素是患者受教育程度低(四项研究),其次是药物费用(三项研究)、收入(三项研究)和疾病相关知识(三项研究)。与大多数入选的研究不同,其中一项研究表明,接受免费药物治疗的个体依从性较差,另一项研究则未能发现依从性与教育水平之间的相关性。
社会经济因素对帕金森病患者的药物依从性产生负面影响。本综述为制定针对患者和人群的干预措施提供了依据,以改善帕金森病的治疗依从性。