Piñeiro F, Gil V, Donis M, Orozco D, Torres M T, Merino J
Departamento de Medicina, Universidad de Alicante.
Aten Primaria. 1997 May 31;19(9):465-8.
To validate six indirect methods of identifying patients who do not comply with their treatment with hypolipaemiant drugs.
A prospective study.
Primary care centres in the province of Alicante.
107 lipaemic patients, on the lists of 5 General Medical practices and on drugs treatment.
The most accurate way to assess compliance was the surprise counting of pills in patients' homes. Patients who had between 80 and 110% compliance were defined as compliant. The six indirect methods validated were: Communication of self-compliance (CS), Attendance at appointments (AA), Doctor's judgment (DJ), Information about the illness (II), the Morisky-Green test (MG) and the grade of control (GC). AA, DJ and CS were the methods with highest specificity (91.2%-89.5%). GC and II were the most sensitive (88%-82%). GC obtained the greatest negative predictive value (77.7%), and DJ the greatest positive predictive value (73.6%). The concordance index (kappa) ranged from 0.23 for GC and -0.002 for II.
GC, DJ and CS are the methods with the best validity indicators and concordance. They could, therefore, be used together in clinical practice to identify patients not complying with their hypolipemiant treatment.
验证六种间接方法，以识别未遵医嘱服用降血脂药物的患者。
前瞻性研究。
阿利坎特省的基层医疗中心。
来自5家普通医疗诊所名单上的107名血脂异常患者，正在接受药物治疗。
评估依从性最准确的方法是突击检查患者家中的药丸数量。依从性在80%至110%之间的患者被定义为依从。经验证的六种间接方法为：自我依从性沟通（CS）、预约就诊（AA）、医生判断（DJ）、疾病信息（II）、Morisky-Green测试（MG）和控制等级（GC）。AA、DJ和CS是特异性最高的方法（91.2%-89.5%）。GC和II是最敏感的方法（88%-82%）。GC获得了最大的阴性预测值（77.7%），DJ获得了最大的阳性预测值（73.6%）。一致性指数（kappa）范围从GC的0.23到II的-0.002。
GC、DJ和CS是有效性指标和一致性最佳的方法。因此，它们可在临床实践中联合使用，以识别未遵医嘱进行降血脂治疗的患者。
