Medication compliance

用药依从性
  • 文章类型: Journal Article
    目的:疼痛是急性疱疹性神经痛(AHN)患者最常见和最有害的症状之一。在这个人群中,确定影响患者服药依从性的原因的研究很少。本研究旨在构建AHN患者用药依从性的预测模型并验证其性能。
    方法:在这项前瞻性研究中,我们对2020年7月至2022年10月从三甲医院出院的398例AHN患者进行药物治疗,采用logistic回归分析,探讨AHN患者药物治疗依从性的预测因素,并构建列线图。曲线下面积用于评估模型的预测效果。
    结果:基于以下四个因素构建了AHN患者药物依从性的预测模型:疾病持续时间,治疗前疼痛严重程度,药物信仰,和慢性疾病的共病。模型曲线下面积为0.766(95%置信区间[0.713,0.819]),最大Youden指数为0.431,敏感性为0.776,特异性为0.655。发现线性校准曲线的斜率接近1。
    结论:本研究构建的预测模型具有良好的预测性能,为临床早期筛选影响AHN患者用药依从性的独立因素提供参考。
    OBJECTIVE: Pain is one of the most common and harmful symptoms experienced by individuals with acute herpetic neuralgia (AHN). In this population, studies to determine the causes that affect patients taking medications compliance are rare. This study aimed to construct a predictive model for medication compliance of patients with AHN and to verify its performance.
    METHODS: In this prospective study of 398 patients with AHN who were discharged from a tertiary hospital with medications from July 2020 to October 2022, we used logistic regression analysis to explore the predictive factors of medication compliance of patients with AHN and to construct a nomogram. The area under the curve was used to evaluate the predictive effect of the model.
    RESULTS: A predictive model of drug compliance of patients with AHN was constructed based on the following four factors: disease duration, pain severity before treatment, medication beliefs, and comorbidity of chronic diseases. The area under the curve of the model was 0.766 (95% confidence interval [0.713, 0.819]), with a maximum Youden\'s index of 0.431, sensitivity of 0.776, and specificity of 0.655. A linear calibration curve was found with a slope close to 1.
    CONCLUSIONS: The prediction model constructed in this study had good predictive performance and provided a reference for early clinical screening of independent factors that affected the medication compliance of patients with AHN.
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  • 文章类型: Journal Article
    背景:阿托品,特别是0.05%的眼药水,已被证明有效减缓近视的发展。本研究旨在探讨使用不同频率的0.05%阿托品滴眼液治疗的近视儿童的周边屈光(PR)特征。
    方法:138名近视儿童完成了这项为期一年的前瞻性研究,随机分配到每天一次(7/7),每周两次(2/7)或每周一次(1/7)组。测量球面当量(SE)和轴向长度(AL)。使用定制的Hartmann-Shack波前外围传感器评估PR,覆盖水平60°和垂直36°的视野。通过从外周测量值减去中心来计算相对外周屈光度(RPR)。
    结果:一年后,与7/7组(P<0.001)和2/7组(P=0.004)相比,1/7组的SE增加更明显;与7/7组相比,1/7组的AL伸长率也更大(P<0.001)。与高频组相比,1/7组在中央凹及其垂直上表现出更多的近视PR,劣等,和鼻视网膜;一年后周边视网膜近视性RPR较少(P<0.05)。此外,7/7组的RPR显示整个视网膜的近视移位,2/7组在颞侧和下视网膜,1/7组视网膜上远视移位(P<0.05)。此外,颞部视网膜RPR的近视移位与近视进展较少有关,7/7组显著(P<0.05)。
    结论:阿托品以频率依赖性方式抑制近视进展。每天一次的组显示出最慢的近视进展,但在RPR中表现出更多的近视变化。此外,颞叶视网膜中的RPR与所有组的近视进展有关。
    背景:中国临床试验注册中心,ChiCTR2100043506。2021年2月21日注册,https://www.chictr.org.cn/showproj.html?proj=122214。
    BACKGROUND: Atropine, specifically 0.05% eyedrops, has proven effective in slowing myopia progression. This study aims to investigate peripheral refraction (PR) characteristics in myopic children treated with 0.05% atropine eyedrops at different frequencies.
    METHODS: One hundred thirty-eight myopic children completed this one-year prospective study, randomly assigned to once daily (7/7), twice per week (2/7), or once per week (1/7) groups. Spherical equivalent (SE) and axial length (AL) were measured. PR was assessed using a custom-made Hartmann-Shack wavefront peripheral sensor, covering a visual field of horizontal 60° and vertical 36°. Relative peripheral refraction (RPR) was calculated by subtracting central from peripheral measurements.
    RESULTS: After one year, SE increased more significantly in the 1/7 group compared to the 7/7 group (P < 0.001) and 2/7 group (P = 0.004); AL elongation was also greater in the 1/7 group compared to the 7/7 group (P < 0.001). In comparison with higher frequency groups, 1/7 group exhibited more myopic PR in the fovea and its vertical superior, inferior, and nasal retina; and less myopic RPR in the periphery retina after one-year (P < 0.05). Additionally, RPR in the 7/7 group demonstrated myopic shift across the entire retina, the 2/7 group in temporal and inferior retina, while the 1/7 group showed a hyperopic shift in the superior retina (P < 0.05). Moreover, myopic shift of RPR in the temporal retina is related to less myopia progression, notably in the 7/7 group (P < 0.05).
    CONCLUSIONS: Atropine inhibits myopia progression in a frequency-dependent manner. The once-daily group showed the slowest myopia progression but exhibited more myopic shifts in RPR. Additionally, RPR in the temporal retina was related to myopia progression in all groups.
    BACKGROUND: Chinese Clinical Trial Registry, ChiCTR2100043506. Registered 21 February 2021, https://www.chictr.org.cn/showproj.html?proj=122214.
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  • 文章类型: Journal Article
    背景:糖皮质激素广泛用于雾化吸入治疗喘息性疾病。本研究旨在探讨监护人对吸入型糖皮质激素(ICS)气雾剂治疗的知识和态度以及中国喘息患儿的用药依从性。
    方法:这项横断面研究于2022年10月至2023年2月在邵阳学院附属第一医院招募了患有喘息疾病的儿童的监护人。开发了一份自我管理的问卷,以收集参与者的人口统计信息,并评估他们对ICS气雾剂治疗的知识和态度。采用8项Morisky服药依从性量表评估儿童的服药依从性。
    结果:共收集有效问卷506份。260名(51.38%)参与者是≤3岁儿童的监护人,327名(64.62%)是儿童的母亲。知识,态度,所有参与者的服药依从性得分分别为12.61±5.78、20.95±2.37和4.69±2.18。多因素logistic回归显示知识得分[OR=1.053,95%CI(置信区间):1.017-1.090,P=0.003],态度得分(OR=1.121,95%CI:1.030-1.219,P=0.008),4-6岁儿童的监护人(OR=0.385,95%CI:0.242-0.612,P<0.001),和儿童的祖父母(OR=2.633,95%CI:1.104-6.275,P=0.029)与儿童的服药依从性独立相关。
    结论:结论:中国儿童喘息疾病监护人知识不足,不满意的态度,对ICS气雾剂治疗的药物依从性差。
    背景:回顾性注册。
    BACKGROUND: Glucocorticoids are widely used in inhalation aerosol therapy for wheezing diseases. This study aims to explore guardians\' knowledge and attitude towards inhaled corticosteroids (ICS) aerosol therapy and the medication compliance of children with wheezing diseases in China.
    METHODS: This cross-sectional study enrolled guardians of children with wheezing diseases at the First Hospital Affiliated to Shaoyang College between October 2022 and February 2023. A self-administered questionnaire was developed to collect demographic information of the participants and evaluate their knowledge and attitude towards ICS aerosol therapy. The 8-item Morisky Medication Adherence Scale was used to assess the medication compliance of children.
    RESULTS: A total of 506 valid questionnaires were collected. 260 (51.38%) participants were guardians of a ≤ 3-year-old child and 327 (64.62%) were children\'s mothers. The knowledge, attitude, and medication compliance scores of all participants were 12.61 ± 5.78, 20.95 ± 2.37, and 4.69 ± 2.18, respectively. Multivariate logistic regression showed that knowledge scores [OR = 1.053, 95% CI (confidence interval): 1.017-1.090, P = 0.003], attitude scores (OR = 1.121, 95% CI: 1.030-1.219, P = 0.008), guardians of children aged 4-6 years (OR = 0.385, 95% CI: 0.242-0.612, P < 0.001), and grandparents of children (OR = 2.633, 95% CI: 1.104-6.275, P = 0.029) were independently associated with children\'s medication compliance.
    CONCLUSIONS: In conclusion, guardians of children with wheezing diseases in China had insufficient knowledge, unsatisfactory attitude, and poor medication compliance towards ICS aerosol therapy.
    BACKGROUND: Retrospectively registered.
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  • 文章类型: Journal Article
    背景:不遵守药物治疗仍然是精神分裂症的一个具有挑战性的问题。一直在研究具有高可行性和可接受性的较新策略。这项研究旨在评估基于技术的干预措施在改善精神分裂症患者用药依从性方面的有效性。
    方法:这是一项前瞻性干预研究,要求参与者使用SuperMD智能手机应用程序(Digital-HealthTechnologiesPteLtd,吉隆坡,马来西亚)一个月。药物依从性评定量表-马来语翻译(MARS-M)和马来语药物依从性量表-9(MDAI-9)评分的变化表明依从性和对药物的态度发生了变化。使用阳性和阴性综合征量表(PANSS)评估症状和洞察力的变化。药物依从性也从SuperMD申请获得。使用配对T检验来评估研究变量的平均得分在研究期间的变化的显著性。采用Wilcoxon符号秩检验分析MDAI-9亚表和PANSS评分的变化。使用Kruskal-Wallis测试来确定洞察力变化对药物依从性水平的影响。
    结果:本研究共有36名参与者。结果显示,依从性有统计学意义的改善(0.65,p≤0.01),但对药物治疗的态度无统计学意义(0.78,p=0.065)。PANNS评分也有改善(-2.58,P≤0.01)。洞察力无明显变化(χ2(2)=3.802,p=0.15)。结论:使用基于技术的策略如SuperMD可有效改善精神分裂症患者的用药依从性。
    BACKGROUND:  Non-compliance to medications remains a challenging problem in schizophrenia. Newer strategies with high feasibility and acceptability are always being researched. This study aimed to assess the effectiveness of technology-based intervention in improving medication compliance in individuals with schizophrenia.
    METHODS: This was a prospective intervention study where participants were required to use the SuperMD smartphone application (Digital-Health Technologies Pte Ltd, Kuala Lumpur, Malaysia) for a month. A change in the Medication Adherence Rating Scale-Malay Translation (MARS-M) and Malay Translation of Drug Adherence Inventory-9 (MDAI-9) scores indicated a change in compliance and attitude to medication. Positive and Negative Syndrome Scale (PANSS) was used to assess change in symptoms and insight. Medication compliance was also obtained from the SuperMD application. Paired T-test was used to evaluate the significance of changes in mean scores of research variables over the study period. Wilcoxon signed-rank test was used to analyze the subscale of MDAI-9 and the change in PANSS score. The Kruskal-Wallis test was used to determine the effect of the change of insight on the level of compliance with medication.
    RESULTS: There were 36 participants in this study. The results showed statistically significant improvement in compliance (0.65, p ≤ 0.01) but not in attitude towards medication (0.78, p = 0.065). There was also an improvement in PANNS score (-2.58, P ≤ 0.01). There was no significant change in insight (χ2(2) = 3.802, p = 0.15).  Conclusion:The use of technology-based strategies like SuperMD is effective in improving medication compliance for individuals with schizophrenia.
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  • 文章类型: Journal Article
    本研究旨在探讨血管危险因素的管理,通过对临床数据的深入分析和对缺血性卒中患者的纵向随访,重点了解影响危险因素控制的各种因素。
    共有1,572名参与者被纳入分析。我们评估了血压(BP)的阈值,低密度脂蛋白胆固醇(LDL-C),和糖化血红蛋白(HbA1c)水平,以揭示影响血管危险因素控制的背景条件和因素。此外,该研究还在发病后3个月,6个月和12个月的时间间隔对药物依从性进行了审查.Logistic回归用于校正混杂因素。
    在3、6和12个月时,BP,LDL,血红蛋白控制目标分别为50.7、51.8和50.6%;51.5、59.4和50.6%;48.1、44.0和48.4%,分别。值得注意的是,年龄与血压控制的实现相关(比值比[OR],0.96;95%置信区间[CI],0.94-0.98;p<0.0001)。少数民族(或,4.23;95%CI,1.19-15.09;p=0.02)和冠心病患者(OR,0.5;95%CI,0.3-1.0;p=0.05)血压控制率下降。以前的中风史(或,1.7;95%CI,1.0-2.8;p=0.03)和不受限制的饮酒(OR,3.3;95%CI,1.0-11.1;p=0.05)与脂质控制的实现显着相关。此外,生活方式的改变与血压控制的实现显着相关(OR,0.19;95%CI,0.12-0.30;p<0.01),血糖控制(OR,0.03;95%CI,0.01-0.08;p<0.01),和血脂控制(OR,0.26;95%CI,0.16-0.42;p<0.01)。缺乏规律的体力活动与较低的血糖率相关(OR,0.14;95%CI,0.06-0.36;p<0.01)和脂质对照(OR,0.55;95%CI,0.33-0.90;p=0.01)。随着时间的推移,总体用药依从性下降.
    在接受药物治疗的患者队列中,血管危险因素的依从率仍不能令人满意.重视二级预防用药的依从性,加强对血管危险因素的控制,随着合规成为有效预防的关键。
    UNASSIGNED: This study aimed to investigate the management of vascular risk factors, with a specific focus on understanding the various factors affecting risk factor control through an in-depth analysis of clinical data and a longitudinal follow-up of patients who have experienced ischemic strokes.
    UNASSIGNED: A total of 1,572 participants were included in the analysis. We assessed thresholds for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and glycated hemoglobin (HbA1c) levels to uncover the contextual conditions and factors affecting vascular risk factor control. Moreover, the study also scrutinized medication compliance at intervals of 3, 6, and 12 months post-onset. Logistic regression was used to adjust for confounding factors.
    UNASSIGNED: At 3, 6, and 12 months, BP,LDL, hemoglobin control targets were achieved in 50.7, 51.8, and 50.6%; 51.5, 59.4, and 50.6%; 48.1, 44.0, and 48.4%,respectively. Notably, age was associated with the achievement of BP control (odds ratio [OR], 0.96; 95% confidence intervals [CI], 0.94-0.98; p < 0.0001). Ethnic minorities (OR, 4.23; 95% CI, 1.19-15.09; p = 0.02) and individuals with coronary heart disease (OR, 0.5; 95% CI, 0.3-1.0; p = 0.05) experienced decreased BP control ratios. A previous history of stroke (OR, 1.7; 95% CI, 1.0-2.8; p = 0.03) and unrestricted alcohol consumption (OR, 3.3; 95% CI, 1.0-11.1; p = 0.05) was significantly associated with the achievement of lipid control. Furthermore, lifestyle modifications were significantly correlated with the achievement of BP control (OR, 0.19; 95% CI, 0.12-0.30; p < 0.01), blood glucose control (OR, 0.03; 95% CI, 0.01-0.08; p < 0.01), and blood lipid control (OR, 0.26; 95% CI, 0.16-0.42; p < 0.01). The absence of regular physical activity was associated with lower rates of glycemic (OR, 0.14; 95% CI, 0.06-0.36; p < 0.01) and lipid controls (OR, 0.55; 95% CI, 0.33-0.90; p = 0.01). Over time, overall medication compliance declined.
    UNASSIGNED: Within the cohort of patients under medication, the compliance rate concerning vascular risk factors remains unsatisfactory. Attention should be paid to compliance with secondary prevention medications and enhance the control of vascular risk factors, as compliance emerges as the key to effective prevention.
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  • 文章类型: Case Reports
    精神分裂症谱系障碍是与全因死亡风险增加相关的精神疾病;与普通人群相比,患有这些病症的患者的平均寿命缩短。精神分裂症谱系疾病的一线治疗包括非典型抗精神病药,与众所周知的副作用有关,包括代谢综合征,抗胆碱能作用,锥体外系症状.我们正在介绍一例接受非典型抗精神病药物利培酮治疗的36岁患者,该患者经历了与治疗相关的尿失禁。在目前的文献中,非典型抗精神病药物引起的尿失禁在精神分裂症谱系障碍患者中没有得到很好的证明.对于许多患者来说,失禁通常是社会耻辱的话题,作为副作用,它可能会影响药物的依从性。在精神分裂症谱系障碍的治疗中,依从性对于防止患者精神病复发至关重要,所以开处方者必须意识到这种潜在的副作用以及如何管理它。当患者出现怀疑是由于非典型抗精神病药物引起的失禁时,必须首先排除其他更常见的尿失禁原因。然后,进一步的管理可以包括停止有问题的药物或添加药物以解决失禁。在这种情况下,我们的病人有长期治疗欠佳的分裂情感障碍病史,利培酮提供了显著的改善;因此,为了确保持续改进,我们开始使用奥昔布宁治疗尿失禁.
    Schizophrenia spectrum disorders are psychiatric conditions associated with an increased risk of all-cause mortality; patients with these conditions have a shortened average lifespan compared to the general population. First-line treatment for schizophrenia spectrum illness consists of atypical antipsychotics, which are associated with well-understood side effects, including metabolic syndrome, anticholinergic effects, and extrapyramidal symptoms. We are presenting a case of a 36-year-old patient treated with the atypical antipsychotic risperidone who experienced treatment-associated urinary incontinence. In the current literature, atypical antipsychotic-induced urinary incontinence is not well-documented in patients with schizophrenia spectrum disorder. Incontinence is often a topic of societal shame for many patients, and as a side effect, it may influence medication compliance. In the treatment of schizophrenia spectrum disorders, compliance is essential to prevent psychosis relapse in patients, so prescribers must be aware of this potential side effect and how to manage it. Upon a patient presenting with incontinence suspected to be due to atypical antipsychotics, other more common causes of incontinence must first be ruled out. Then, further management can consist of stopping the offending medication or adding a medication to address the incontinence. In this case, our patient had an extended history of suboptimal treated schizoaffective disorder, and risperidone was providing significant improvement; therefore, to ensure continued improvement, we initiated oxybutynin to manage urinary incontinence.
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  • 文章类型: Journal Article
    目的:关于家庭护理的有限证据和长期个性化随访的需求强调了开发基于互联网的随访平台以支持闭塞性细支气管炎(BO)患儿的看护人的重要性。本研究旨在通过比较家庭管理来探索和测试该平台的潜在收益,药物依从性和临床系统。
    方法:双臂,本研究于2022年1月至2022年10月对168名BO儿童及其家庭进行了单盲随机对照试验.家庭随机分为网络随访组和常规随访组,比例为1:1。家庭管理措施(FaMM)的分数,在三个时间点收集两组的8项Morisky药物依从性(8-MMAS)和BO临床症状:出院当天(T1),出院后3个月(T2),出院后6个月(T3)。通过重复测量方差分析比较各组因干预引起的变化。
    结果:90个家庭完成了试验,其中互联网随访组48人,常规随访组42人。结果显示,不同时间的群体互动对儿童日常生活得分有显著差异,病情管理能力与父母相互关系(p<0.05)。在“状况影响”和“家庭生活困难”的评分上没有发现按时间分组的影响。BO临床症状和MMAS-8评分显示组内,组间,和按时间分组的效果。
    结论:基于互联网的随访平台可以授权护理人员加强有效的家庭管理,改善BO儿童的用药依从性,缓解患者的临床症状。
    背景:ChiCTR2200065121(2022年4月28日)中国临床试验注册中心。
    OBJECTIVE: Limited evidence on home care and need for long-term individualized follow-up highlight the importance of developing an Internet-based follow-up platform to support caregivers of children with Bronchiolitis Obliterans (BO). This Study aims to explore and test the potential benefits of this platform by comparing family management, medication compliance and clinical systems.
    METHODS: A two-arm, single-blind randomized controlled trial was conducted on 168 children with BO and their families from January 2022 to October 2022. Families were randomly divided into Internet-based follow-up group and conventional follow-up group with a ratio of 1:1. Scores of family management measures (FaMM), 8-item of Morisky Medication Adherence (8-MMAS) and BO clinical symptoms of both groups were collected at three points of time: the day of discharge (T1), 3 months after discharge (T2), and 6 months after discharge (T3). The changes of each group due to intervention were compared by repeated-measures ANOVA.
    RESULTS: 90 families completed the trial, including 48 in the Internet-based follow-up group and 42 in the conventional follow-up group. The results showed a significant difference in the group-by-time interaction on the scores of Child\'s Daily Life, Condition Management Ability and Parental Mutuality (p < 0.05). No group-by-time effect was found on the scores of View of Condition Impact and Family Life Difficulty. Scores of BO clinical symptoms and MMAS-8 showed intra-group, inter-group, and group-by-time effects.
    CONCLUSIONS: The Internet-based follow-up platform can empower caregivers in enhancing effective family management, improving medication compliance in children with BO, and relieving patients\' clinical symptoms.
    BACKGROUND: Chinese Clinical Trials Registry of ChiCTR2200065121 (04/28/2022).
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  • 文章类型: Journal Article
    特应性皮炎是一种慢性皮肤病,需要延长治疗时间并局部应用药物。虽然特应性皮炎治疗在按指示使用时可以非常有效,通常患者没有预期的反应,提高对无依从性和无反应的关注。本章旨在描述目前已知的特应性皮炎的依从性,并讨论改善依从性以改善治疗结果的策略。无论是有意还是无意,由于多种原因,不坚持治疗会限制患者的预后.这些包括对药物疗效的挫败感,不便,和对副作用的恐惧。其他因素包括健忘,治疗的经济负担,对医生缺乏信任,不喜欢处方药,或对疾病或治疗缺乏了解。已经研究了几种干预措施,旨在提高特应性皮炎的依从性,例如针对患者和护理人员的教育研讨会,较早的后续访问,和短信提醒——然而,这些通常受到样本量和功率的限制。需要进一步的研究来研究特应性皮炎中两种特定的非依从性模式,以及改进它们的方法。
    Atopic dermatitis is a chronic dermatologic condition requiring extended treatment times with topical application of medications. While atopic dermatitis treatments can be highly effective when used as directed, oftentimes patients do not respond as expected, raising concern for nonadherence versus nonresponse. This chapter aims to describe what is currently known about adherence in atopic dermatitis and to discuss strategies to improve adherence in order to improve treatment outcomes. Whether intentional or unintentional, nonadherence to treatment can limit patient outcomes of this disease for a variety of reasons. These include frustration with medication efficacy, inconvenience, and fear of side effects. Other factors include forgetfulness, financial burden of treatment, lack of trust in the physician, dislike of prescribed medication, or lack of understanding of disease or treatment. Several interventions have been studied with the aim of improving adherence in atopic dermatitis-such as educational workshops for patients and caregivers, earlier follow-up visits, and text messages reminders-however, these are often limited by sample size and power. Further research is needed to study both specific patterns of nonadherence in atopic dermatitis, as well as methods to improve them.
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  • 文章类型: English Abstract
    调查中国西部某地区精神分裂症患者的服药依从性和各种危险行为的现状,并据此探讨两者之间的相关性。
    在2006年至2018年期间,共有292667名精神分裂症患者参加了随访调查。此外,基于结果范围分析策略,采用多变量Cox比例风险回归模型,评估和比较精神分裂症患者服药依从性对不同类型危险行为的影响.
    在这个为期13年的前瞻性队列中,65175名患者(31.4%)表现出良好的服药依从性,而142394例(68.6%)患者的服药依从性较差。随访期间各种危险行为的发生率如下,轻微的滋扰,12.25%,违反《中华人民共和国治安管理处罚法》(APS法),3.82%,触犯刑法,0.94%,自杀完成,0.28%,自我伤害,1.42%,并企图自杀,0.82%。与服药依从性良好的精神分裂症患者相比,服药依从性差的精神分裂症患者对他人实施暴力和自我伤害的风险更高。相关影响是轻微的滋扰(危险比[HR]=1.31,95%置信区间[CI]:1.27-1.35),违反APS法(HR=1.47,95%CI:1.38-1.56),违反刑法(HR=1.17,95%CI:1.05-1.31),和自我伤害(HR=1.43,95%CI:1.32-1.56),分别,而服药依从性差的精神分裂症患者完成自杀的风险低于服药依从性好的患者(HR=0.56,95%CI:0.47-0.66).尝试自杀和药物依从性之间没有统计学上的显着关联。
    药物依从性与不同类型的危险行为之间的关联方向和强度存在差异,需要进一步研究以阐明关联的机制。
    UNASSIGNED: To investigate the status of medication adherence and various types of risky behaviors of schizophrenia patients in a certain area of western China and to explore accordingly the correlation between the two.
    UNASSIGNED: A total of 292 667 patients with schizophrenia were enrolled in a follow-up survey between 2006 and 2018. In addition, based on the outcome-wide analysis strategy, a multivariate Cox proportional risk regression model was used to estimate and compare the impact of medication adherence on different types of risky behaviors in schizophrenia patients.
    UNASSIGNED: In this 13-year prospective cohort, 65 175 patients (31.4%) showed good medication adherence, while 142 394 patients (68.6%) showed poor medication adherence. The incidence rates of various risky behaviors during the follow-up period were as follows, minor nuisances, 12.25%, violation of the Law of the People\'s Republic of China on Penalties for Administration of Public Security (APS law), 3.82%, violation of criminal law, 0.94%, suicide completed, 0.28%, self-harm, 1.42%, and attempted suicide, 0.82%. Schizophrenia patients who had poor medication adherence had higher risks of committing violence against others and self-inflicted injury compared to patients with good medication adherence did, with the associated effects being minor nuisances (hazard ratio [HR]=1.31, 95% confidence interval [CI]: 1.27-1.35), violation of APS law (HR=1.47, 95% CI: 1.38-1.56), violation of criminal law (HR=1.17, 95% CI: 1.05-1.31), and self-harm (HR=1.43, 95% CI: 1.32-1.56), respectively, while the risk of suicide completed is lower in schizophrenia patients with poor medication adherence than that in patients with good medication adherence (HR=0.56, 95% CI: 0.47-0.66). There was no statistically significant association between attempted suicide and medication adherence.
    UNASSIGNED: There are variations in the direction and strength of the association between medication adherence and different types of risky behaviors and further research is needed to elucidate the mechanisms of the association.
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  • 文章类型: Systematic Review
    目的:服药依从性在改善与糖尿病和合并症相关的健康结局方面发挥着重要作用。迄今为止,尚未综合影响药物依从性的潜在因素以及它们如何促进健康行为。这篇综述综合了定性研究,这些研究确定了影响糖尿病和合并症成年人用药依从性的因素。
    结果:提取了28个发现,并将其合成为四个主题:感知支持,缺乏知识,药物问题,例行公事的重要性。研究结果强调了支持药物依从性的因素以及可以针对支持和促进药物依从性的领域。研究结果还支持医疗保健提供者在支持糖尿病和合并症患者坚持和维持药物治疗方案方面的潜在作用。确定了几个因素,这些因素可以在临床实践环境中进行干预,并且有可能增强药物依从性并改善糖尿病和合并症患者的健康结果。开发可接受和有效的干预措施可能对药物依从性和健康结果产生积极影响。
    Medication adherence plays an important role in improving health outcomes related to diabetes and comorbidity. The potential factors influencing medication adherence and how they contribute to health behaviors have not been synthesized to date. This review synthesized qualitative studies that identified factors influencing medication adherence among adults living with diabetes and comorbidity.
    Twenty-eight findings were extracted and synthesized into four themes: perceived support, lack of knowledge, medication issues, and the importance of routine. The findings highlight the factors that support medication adherence and areas that can be targeted to support and promote medication adherence. The findings also support the potential role of healthcare providers in supporting people living with diabetes and comorbidity to adhere to and maintain medication regimes. Several factors were identified that are amenable to intervention within the clinical practice setting and have the potential to enhance medication adherence and improve health outcomes for people living with diabetes and comorbidities. The development of acceptable and effective interventions could have a positive effect on medication adherence and health outcomes.
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