疟疾是一种可以治愈的疾病,需要早期诊断和治疗,连同矢量的消除,是主要的控制工具。不坚持抗疟药治疗可能导致治疗失败,抗疟药抗性的发展,疟疾在非流行地区的引入或复发,增加医疗费用。文献描述了几种直接或间接评估治疗依从性的方法。但不存在黄金标准。这篇综述的主要目的是系统化用于评估患者对抗疟治疗依从性的方法。进行了系统审查,根据PRISMA声明,以下数据库:LILACS,EMBASE,pubmed,Cochrane,GOOGLE学者,WEB的科学,Scopus,和Opengray,2021年12月14日通过筛选纳入研究的参考文献以及相关评论中引用的参考文献,还进行了滚雪球搜索。纳入标准是报告评估患者在实验室诊断为疟疾的个体中对抗疟药的依从性,规定的抗疟药物的描述,和依从性估计。排除标准是专门关于直接观察治疗的研究,人口≤12岁的研究和指南,评论,reviews,信件,或社论。使用MINORS和Cochrane偏差风险工具评估研究质量。将物品的数量作为分母来计算比例以测量频率。本综述包括21项研究。他们中的大多数(76.5%)评估了对恶性疟疾治疗的依从性。17项研究(80.9%)使用了多种方法。所描述的方法是药丸计数,自我报告,生物测定,使用电子药盒,和临床治愈。可以为所有使用的方法确定不同的依从性分类。我们的评论发现,像药丸计数和自我报告这样的间接方法是最常用的。结合一种提供药物摄入确凿证据的方法和一种用有关因素的信息完成研究的方法,信念或坚持的障碍似乎是最好的方法。抗疟药治疗的未来研究应规范依从性分类,并收集有关不依从的类型和原因的数据,这可以促进工具的发展,以促进药物依从性。系统审查注册:https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42020148054,标识符CRD42020148054。
Malaria is a curable disease for which early diagnosis and treatment, together with the elimination of vectors, are the principal control tools. Non-adherence to antimalarial treatment may contribute to therapeutic failure, development of antimalarial resistance, introduction or resurgence of malaria in non-endemic areas, and increased healthcare costs. The literature describes several methods to directly or indirectly assess adherence to treatment, but no gold standard exists. The main purpose of this review is to systematize the methods used to assess patient adherence to antimalarial treatment. A systematic
review was performed, in accordance with the PRISMA statement, of the following databases: LILACS, EMBASE, PUBMED, COCHRANE, GOOGLE SCHOLAR, WEB OF SCIENCE, SCOPUS, and OPENGREY, through 14 December 2021. A snowball search was also performed by screening the references of the included studies as well as those cited in relevant reviews. Inclusion criteria were reporting assessment of the patient\'s adherence to antimalarials in individuals with laboratory diagnosis of malaria, the description of antimalarials prescribed, and adherence estimates. Exclusion criteria were studies exclusively about directly observed therapy, studies of populations ≤12 yo and guidelines, commentaries, reviews, letters, or editorials. Study quality was assessed using MINORS and the Cochrane Risk of Bias Tool. Proportions were calculated to measure frequencies considering the number of articles as the denominator. Twenty-one studies were included in this
review. Most of them (76.5%) assessed adherence to falciparum malaria treatment. Seventeen studies (80.9%) used a combination of methods. The methods described were pill counts, self-reports, biological assays, use of electronic pillboxes, and clinical cure. It was possible to identify different adherence classifications for all the methods used. Our
review found that indirect methods like pill counts and self-reports are the most commonly used. Combining an
method that gives solid proof of the ingestion of medication and a
method that completes the research with information regarding factors, beliefs or barrier of adherence seems to be the best approach. Future studies of antimalarial treatment should standardize adherence classifications, and collect data on the types and causes of nonadherence, which can contribute to the development of tools to promote medication adherence. Systematic
Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020148054, identifier CRD42020148054.