Gil V F, Belda J, Muñoz C, Martínez J L, Soriano J E, Merino J
Departmento de Medicina, Universidad de Alicante.
Rev Clin Esp. 1993 Nov;193(7):363-7.
To validate 4 indirect methods for detecting therapeutic non-compliance in 157 patients in a community health center Centro de Salud "Carrus" in Elche, Alicante.
The methods employed are self related compliance (SC), therapeutic gains obtained, Morinsky-Green Test, and the level of knowledge of Batalla disease (LK). For verification purposes, pills were counted, allowing the formation of 2x2 tables to calculate indices of validity. The statistical analysis employed is the calculation of 95% confidence intervals.
SC yields significantly the lowest sensitivity (13.7 +/- 7.9%) and the highest specificity (85.7% +/- 7.5%). The LK presents the highest sensitivity 79.5 +/- 9.3%. SC underestimates non-compliance (32.5%) significantly, and the LK overestimates noncompliance (23.6%).
The LK is a good method for detecting problems of low compliance and SC those of high compliance. It is recommended that both methods should be employed in a systematic fashion in clinical practice. However, the LK and SC cannot be used to calculate prevalences of therapeutic noncompliance in population-based studies.
验证4种间接方法在阿利坎特省埃尔切市“卡鲁斯”社区卫生中心对157例患者治疗不依从性的检测效果。
采用的方法有自我相关依从性(SC)、获得的治疗效果、莫林斯基-格林测试以及对巴塔拉病的知晓水平(LK)。为进行验证,对药片进行计数,从而形成2×2表格以计算有效性指标。所采用的统计分析方法是计算95%置信区间。
SC的灵敏度显著最低(13.7±7.9%),特异性最高(85.7%±7.5%)。LK的灵敏度最高,为79.5±9.3%。SC显著低估了不依从性(32.5%),而LK高估了不依从性(23.6%)。
LK是检测低依从性问题的良好方法,SC是检测高依从性问题的方法。建议在临床实践中系统地运用这两种方法。然而,在基于人群的研究中,LK和SC不能用于计算治疗不依从性的患病率。