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Abstract：
Background: Adherence to therapy is one of the most important elements during the therapeutic process ensuring the predefined therapeutic outcomes. The aim is to analyze the need and importance of treatment adherence guideline for acromegaly patients and the possibilities for its development and implementation in Bulgaria. Methods: A set of methods was applied: (1) a literature review in the electronic database for identification of articles and guidelines related to adherence and acromegaly; (2) analysis of Bulgarian legislative documents; (3) a pilot study for assessment of the level of treatment adherence among hospitalized Bulgarian acromegaly patients in 2018; (4) a plan for development and implementation of specific guideline was created entitled BULMEDACRO - BULgarian guideline for MEdication aDherence assessment and improvement in ACROmegaly. Results: No specific guidelines for evaluation, monitoring, reporting and/or improving adherence in acromegaly patients has been found in the literature. Requirements for regular assessment of the level of adherence, application of appropriate methods for improvement and monitoring are not sufficiently formulated and mandatory. The pilot study confirmed that therapy adherence among Bulgarian patients with acromegaly is relatively high as almost 90% of patients report that they strictly comply with their prescribed treatment regimen. It is necessary, however, a specific guideline focused on the methods for assessment and improvement of adherence, in order to ensure monitoring and follow-up of acromegaly patients. Conclusions: Patients with acromegaly should be the focus of specially designed national programs, initiatives and/or guidelines for regular evaluation and improvement of the adherence level. Despite the difficulties and the lack of an adequate legal basis, successive steps initiated by different stakeholder are needed.
摘要：
背景：坚持治疗是治疗过程中确保预定义治疗结果的最重要因素之一。目的是分析肢端肥大症患者治疗依从性指南的需求和重要性，以及在保加利亚制定和实施该指南的可能性。方法：应用了一系列方法：（1）在电子数据库中进行文献综述，以识别与依从性和肢端肥大症相关的文章和指南；（2）分析保加利亚立法文件；（3）2018年对住院的保加利亚肢端肥大症患者的治疗依从性水平进行评估的初步研究；（4）制定了一项名为“BULMEDACRO-BULmegalarian指南”的特定指南的制定和实施计划。结果：没有具体的评估指南，监测,在文献中发现了肢端肥大症患者的报告和/或改善依从性.对遵守水平的定期评估的要求，适当的改进和监测方法的应用没有充分制定和强制性。初步研究证实，保加利亚肢端肥大症患者的治疗依从性相对较高，因为近90％的患者报告说他们严格遵守其规定的治疗方案。这是必要的,然而,一个具体的指导方针侧重于评估和改进依从性的方法，以确保肢端肥大症患者的监测和随访。结论：肢端肥大症患者应成为专门设计的国家计划的重点，定期评估和提高遵守水平的倡议和/或准则。尽管困难重重,缺乏充分的法律依据,需要由不同的利益相关者发起的连续步骤。
