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慢性阻塞性肺疾病患者服药行为的障碍与促进因素:一项定性访谈研究

Barriers and enablers to medicine-taking behaviours in chronic obstructive pulmonary disease: a qualitative interview study.

作者信息

Nygård Torbjørn, Wright David, Kjome Reidun L S, Nazar Hamde, Aarli Bernt, Raddum Aase

机构信息

Centre for Pharmacy, Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.

School of Healthcare, University of Leicester, Leicester, UK.

出版信息

Int J Clin Pharm. 2025 Jun;47(3):775-783. doi: 10.1007/s11096-025-01872-9. Epub 2025 Feb 5.

Abstract

BACKGROUND

Chronic Obstructive Pulmonary Disease (COPD) is associated with low health-related quality of life and high costs to healthcare systems, particularly due to hospital admissions and exacerbations. Medicines, inhalers especially, reduce the risk of hospitalisations and exacerbations, but factors influencing medicine-taking behaviours are not fully understood.

AIM

To explore experiences of people with COPD related to medicines, and followingly identify and characterise any barriers and enablers related to medicine-taking behaviours using the Theoretical Domains Framework (TDF).

METHOD

Semi-structured qualitative interviews were conducted and included ten people with COPD who had previously been admitted to hospital. Systematic text condensation was used inductively in the primary analysis of the interviews. In the secondary analysis, meaning units from the primary analysis were mapped to the TDF and summarised as barriers and enablers.

RESULTS

Five major themes were developed in the primary analysis: (1) health literacy and information needs, (2) patient autonomy, (3) lack of access to medicines, (4) lack of effect from medicines, and (5) experiences of medicines-related issues. In the secondary analysis, thirteen barriers and nine enablers were mapped to nine out of the fourteen domains of the TDF.

CONCLUSION

People with COPD experience challenges related to medicines which need to be addressed by researchers and healthcare providers. The identified barriers and enablers mapped to the TDF can guide and inform future design of interventions and health care services.

摘要

背景

慢性阻塞性肺疾病(COPD)与健康相关生活质量低下以及医疗系统的高成本相关,尤其是由于住院和病情加重。药物,特别是吸入器,可降低住院和病情加重的风险,但影响用药行为的因素尚未完全明确。

目的

探讨慢性阻塞性肺疾病患者与药物相关的经历,并随后使用理论领域框架(TDF)识别和描述与用药行为相关的任何障碍和促进因素。

方法

进行了半结构化定性访谈,包括10名曾住院的慢性阻塞性肺疾病患者。在访谈的初步分析中归纳性地使用了系统文本浓缩法。在二次分析中,将初步分析中的意义单元映射到TDF,并总结为障碍和促进因素。

结果

在初步分析中形成了五个主要主题:(1)健康素养和信息需求,(2)患者自主性,(3)药物获取困难,(4)药物无效,以及(5)药物相关问题的经历。在二次分析中,13个障碍和9个促进因素被映射到TDF的14个领域中的9个。

结论

慢性阻塞性肺疾病患者在药物方面面临挑战,研究人员和医疗服务提供者需要加以解决。映射到TDF的已识别障碍和促进因素可为未来干预措施和医疗服务的设计提供指导和参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b295/12125152/17cfc2697d24/11096_2025_1872_Fig1_HTML.jpg

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