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过敏性疾病和哮喘中的药物依从性:文献综述

Medication adherence in allergic diseases and asthma: a literature review.

作者信息

Malaya Elizabeth, Piątkowska Adrianna, Panek Michał, Kuna Piotr, Kupczyk Maciej, Kardas Grzegorz

机构信息

Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.

出版信息

Front Pharmacol. 2024 Dec 2;15:1488665. doi: 10.3389/fphar.2024.1488665. eCollection 2024.

Abstract

Patients' collaboration with healthcare providers, along with their individual dedication to follow medical recommendations, is a crucial component of effective therapy in chronic diseases. If a patient fails to fill their prescription, administers the medication improperly in terms of method and/or dosage, misses follow-up visits, or discontinues the treatment for any reason, these lapses can adversely affect disease management, impairing the effectiveness of symptom relief and prevention of progression and complications. A comparable situation pertains to allergic diseases, which require long-term and consistent treatment to achieve symptom alleviation and control. Research has shown that adherence rates for long-term therapy in chronic diseases have improved marginally over the years and continue to hover at approximately the figure published in a World Health Organization (WHO) report "Adherence to long-term therapies: evidence for action." from 2003, which had stated that only 50% of patients in developed countries follow medical recommendations and that this rate would be even lower in developing countries. Over 20 years later, literature indicated that there has been only a slight improvement on the matter, leaving room for developing and implementing effective solutions to improve medication compliance. Further investigation on this matter is required. Causes for non-adherence classified by the Global Initiative for Asthma in their main report seem to correspond to those of the report by the WHO. Similar dependency might be determined by other allergic diseases as they fit chronic disease criteria, and the issue of non-adherence affects them too. This literature review seeks to compile and synthesize current insights on factors that influence adherence, as well as explore potential methods for monitoring, evaluating, and improving its outcomes in chronic diseases related to the medical field of allergology, such as asthma, allergic rhinitis, allergic conjunctivitis, rhinoconjunctivitis, atopic dermatitis, and urticaria.

摘要

患者与医疗服务提供者的合作,以及他们个人遵循医疗建议的自觉性,是慢性病有效治疗的关键组成部分。如果患者未按处方取药、在用药方法和/或剂量方面不当用药、错过随访预约或因任何原因中断治疗,这些失误会对疾病管理产生不利影响,削弱症状缓解以及预防病情进展和并发症的效果。类似的情况也适用于过敏性疾病,这类疾病需要长期持续治疗才能实现症状缓解和控制。研究表明,多年来慢性病长期治疗的依从率略有提高,但仍停留在世界卫生组织(WHO)2003年发布的一份报告《长期治疗的依从性:行动证据》中的大致水平。该报告指出,发达国家只有50%的患者遵循医疗建议,而在发展中国家这一比例会更低。20多年后,文献表明这一情况仅略有改善,仍有空间开发和实施有效的解决方案来提高用药依从性。对此问题需要进一步研究。全球哮喘防治创议在其主要报告中分类列出的不依从原因似乎与WHO报告中的一致。其他符合慢性病标准的过敏性疾病可能也存在类似的相关性,不依从问题同样会影响它们。这篇文献综述旨在汇编和综合当前关于影响依从性的因素的见解,并探索在与变态反应学医学领域相关的慢性病(如哮喘、过敏性鼻炎、过敏性结膜炎、鼻结膜炎、特应性皮炎和荨麻疹)中监测、评估和改善依从性结果的潜在方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388e/11646763/9294831fcacc/fphar-15-1488665-g001.jpg

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