Wright E C
Lifecare NHS Trust, Caterham, Surrey, UK.
Lancet. 1993 Oct 9;342(8876):909-13. doi: 10.1016/0140-6736(93)91951-h.
The compliance of patients with medication prescribed for them is a challenge. It seems that one-third of patients comply adequately, one-third more-or-less, and one-third are non-compliant, so that compliance rates hover around 50%. This can be improved upon, but not by treating failure to comply as a deplorably aberrant behaviour. First we need to know more about compliance and non-compliance, and that means standardising methods of study and measuring, by questioning the patient, counting tablets, or looking at drug metabolites or markers in faeces, blood or urine. Doctors' prejudices and patients' perceptions alike have to be taken into account since strategies for improvement must include both educating the prescriber and counselling the patient.
让患者遵医嘱服药是一项挑战。似乎有三分之一的患者能充分遵医嘱，三分之一或多或少遵医嘱，还有三分之一不遵医嘱，因此遵医嘱率徘徊在50%左右。这是可以改善的，但不能将不遵医嘱视为应受谴责的异常行为。首先，我们需要更多地了解遵医嘱和不遵医嘱的情况，这意味着要通过询问患者、清点药片或检测粪便、血液或尿液中的药物代谢物或标志物来规范研究和测量方法。医生的偏见和患者的认知都必须考虑在内，因为改进策略必须包括对开处方者进行教育和对患者进行咨询。
