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[利用社区药房电子处方分析用药依从性:“REACT”研究]

[Analysis of medication adherence using electronic prescriptions in a community pharmacy: 'REACT' study].

作者信息

Bonilla Guijarro Amparo, Bailén Maria, Hernando Asunción

机构信息

Doctora en Biomedicina y Ciencias de la Salud. Farmacia Comunitaria Amparo Bonilla, Madrid. España.

Doctora en Farmacia. Universidad Autónoma de Madrid Universidad Autónoma de Madrid España.

出版信息

Farm Comunitarios. 2023 Jan 2;15(1):41-55. doi: 10.33620/FC.2173-9218.(2023).05.

Abstract

BACKGROUND

Patients` lack of adherence to pharmacological treatments has a major impact, both clinical and economical. While different methods are used to measure adherence, retrospective studies are being used more frequently as they are more objective, less prone to bias by patient perception and interfere less with patients' lives. The electronic prescription system provides the community pharmacy with a useful tool to conduct this research.

OBJECTIVE

To measure the adherence of patients to their chronic medication considering different therapeutic drug groups and their mental health using electronic prescription information available in a database.

METHODS

An observational, ambispective and logitudinal study was developed for 300 patients. Adherence was assessed using Proportion of Days Covered (PDC) per patient and per treatment and the Morisky Green Levine test. Data on patients' dispensed medication for the last 12 months was obtained through the electronic prescription system. Data on patient mental health was gathered using the PHQ-2 screen for depression.

RESULTS

A total of 300 patients were recruited, but only 290 were included in the analysis. 25.5%; [95%CI: 20.6:30.9] were classified as polymedicated. The median PDC per patient was 0.90 (IQR: 0.73 - 1). According to the Morisky Green Levine questionnaire, 57.9% of the patients [95%CI 52.0:63.6] adhered to their treatments. Concurrence between the Morisky Green Levine test and the PDC had a kappa k=0.086.

CONCLUSION

The electronic prescription turned out to be a useful tool to gain insight into adherence to long-term treatments measured in terms of the PDC.

摘要

背景

患者对药物治疗缺乏依从性具有重大的临床和经济影响。虽然使用了不同的方法来衡量依从性,但回顾性研究因其更客观、受患者认知偏差影响较小且对患者生活干扰较小而被更频繁地使用。电子处方系统为社区药房开展这项研究提供了一个有用的工具。

目的

利用数据库中可用的电子处方信息,考虑不同治疗药物组及其心理健康状况,衡量患者对慢性药物治疗的依从性。

方法

对300名患者开展了一项观察性、双向性和纵向研究。使用每位患者和每种治疗的覆盖天数比例(PDC)以及莫利斯基-格林-莱文测试来评估依从性。通过电子处方系统获取患者过去12个月的配药数据。使用PHQ-2抑郁筛查量表收集患者心理健康数据。

结果

共招募了300名患者,但仅290名纳入分析。25.5%;[95%置信区间:20.6:30.9]被归类为用药过多。每位患者的PDC中位数为0.90(四分位间距:0.73 - 1)。根据莫利斯基-格林-莱文问卷,57.9%的患者[95%置信区间52.0:63.6]坚持治疗。莫利斯基-格林-莱文测试与PDC之间的一致性kappa系数k = 0.086。

结论

事实证明,电子处方是深入了解以PDC衡量的长期治疗依从性的有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b60/11326682/d8b3b9780330/FC15-01-05_gf02.jpg

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