Morris L S, Schulz R M
United HealthCare Corporation, Minneapolis, Minnesota.
Clin Ther. 1993 May-Jun;15(3):593-606.
There has been increasing interest in using outcomes-based research to evaluate quality of care. Compliance with prescribed regimens is an intermediate outcome measure that presumes that a positive health outcome will follow, which is why clinicians and researchers are interested in compliance. Patients, however, use a variety of criteria to determine the value of medication. They may place equal or greater value on personal and often competing nonclinical outcomes. A small but growing literature explores the influence of physical, economic, psychological, and social factors that influence medication use behavior. This literature supports the notion that patients evaluate medication based not only on its clinical effectiveness, but also how it affects all aspects of their lives. Outcomes research on compliance with prescribed medicine should recognize the outcomes valued from the patient's perspective.
使用基于结果的研究来评估医疗质量的兴趣与日俱增。遵循规定的治疗方案是一种中间结果指标，它假定随后会有积极的健康结果，这就是临床医生和研究人员对依从性感兴趣的原因。然而，患者会使用各种标准来确定药物的价值。他们可能对个人的、往往相互冲突的非临床结果给予同等或更大的重视。一小部分但数量在不断增加的文献探讨了影响用药行为的身体、经济、心理和社会因素。这些文献支持这样一种观点，即患者评估药物不仅基于其临床疗效，还基于它如何影响他们生活的各个方面。关于遵循处方药的结果研究应该认识到从患者角度所重视的结果。
