Tan Ngiap Chuan, Joshi Shashank R, De-Madaria Enrique, Mostafa Badr Eldin, Özgirgin O Nuri, Simoncini Tommaso, Tokgözoğlu Lale
SingHealth Polyclinics, Singapore, Singapore.
Joshi Clinic, Mumbai, India.
Front Pharmacol. 2025 Aug 15;16:1636806. doi: 10.3389/fphar.2025.1636806. eCollection 2025.
Medication non-adherence (NA) remains a persistent challenge across all medical specialties, contributing to adverse patient outcomes and increased healthcare burdens. While numerous studies have explored patient-related factors influencing adherence, the perspectives of healthcare professionals remain underrepresented in literature. This study aims to document the individual experiences of seven international physicians across diverse medical fields, highlighting barriers, detection methods, and strategies employed to address NA in their daily practice.
A structured qualitative approach was employed, incorporating semi-structured interviews and written questionnaires to capture expert insights. Seven physicians from specialties including family medicine, gastroenterology, otolaryngology, otology and neurotology, obstetrics and gynecology, endocrinology and cardiology participated in the study. Data were analyzed thematically to identify recurring patterns, specialty-specific challenges, and practical solutions implemented by clinicians.
Clinicians reported that NA detection primarily relied on patient self-reporting, clinical markers, and medication reconciliation. Barriers to adherence varied by specialty but commonly included polypharmacy, treatment complexity, patient skepticism, socioeconomic constraints, and asymptomatic conditions. Strategies to enhance adherence encompassed patient education, shared decision-making, therapeutic simplification, digital tools, and team-based care models. Despite proactive efforts, clinicians cited systemic limitations such as time constraints, fragmented healthcare records, and inadequate adherence-tracking mechanisms.
Addressing NA requires a patient-centered, interdisciplinary approach integrating education, digital innovations, and structured follow-up strategies. The study underscores the necessity for larger-scale research to validate adherence interventions and refine multidisciplinary frameworks. Given the study's qualitative nature and small sample size, future research should incorporate broader datasets and diverse healthcare perspectives to develop more comprehensive adherence solutions.
药物治疗不依从(NA)仍然是所有医学专科领域长期面临的挑战,会导致不良的患者预后并增加医疗负担。虽然众多研究探讨了影响依从性的患者相关因素,但医疗保健专业人员的观点在文献中仍未得到充分体现。本研究旨在记录七位来自不同医学领域的国际医生的个人经历,突出他们在日常实践中遇到的障碍、检测方法以及为解决药物治疗不依从问题所采用的策略。
采用结构化定性方法,结合半结构化访谈和书面问卷来获取专家见解。来自家庭医学、胃肠病学、耳鼻喉科、耳科学与神经耳科学、妇产科、内分泌学和心脏病学等专科的七位医生参与了该研究。对数据进行主题分析,以识别反复出现的模式、特定专科的挑战以及临床医生实施的实际解决方案。
临床医生报告称,药物治疗不依从的检测主要依赖患者自我报告、临床指标和用药核对。依从性的障碍因专科而异,但通常包括多种药物治疗、治疗复杂性、患者怀疑态度、社会经济限制以及无症状情况。提高依从性的策略包括患者教育、共同决策、治疗简化、数字工具和基于团队的护理模式。尽管做出了积极努力,但临床医生指出了一些系统限制,如时间限制、医疗记录碎片化以及依从性跟踪机制不完善。
解决药物治疗不依从问题需要以患者为中心的跨学科方法,整合教育、数字创新和结构化的随访策略。该研究强调了进行大规模研究以验证依从性干预措施并完善多学科框架的必要性。鉴于该研究的定性性质和小样本量,未来的研究应纳入更广泛的数据集和不同的医疗保健观点,以制定更全面的依从性解决方案。