[Relationship between the experience of steroids side effects and noncompliance with oral steroids treatment in collagen disease patients].

K Hamano, A Ohta, K Masamura, N Hashiguchi, A Takekuma, O Ushiyama, N Suzuki, E Inoue, N Inoue, K Nagasawa
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Abstract

Purpose: To analyze the relationship between the experience of side effect and the compliance with oral steroids drug treatment of the patients in Collagen Disease Clinic.

Methods: A questionnaire survey through interview was conducted on 165 outpatients with various collagen disease at Saga Medical School Hospital.

Results: 94 patients (57%) had a history of noncompliance to the steroids drug. 49 patients (52.1%) adventitiously had forgotten to take the steroids as ordered and 45 patients (47.9%) intentionally had regulated their steroids dose or had discontinued the steroids drug treatment. Over 80% of the patients had experienced side effects of the steroids. The patients who experienced one or more of the following side effects, osteoporosis, bone fractures, menstrual disorders, moon face, central obesity, alopecia, acnelike eruption, manic-depressive state, and insomnia, intentionally regulated, or discontinued the steroids therapy. In addition, the patients who were not made cognizance about side effects of the steroids by their physicians and nurse tended to noncompliance group.

Conclusion: To increase the compliance rate with oral steroids drug treatment, we must make conscious efforts to inform the patients on the condition of their medical states, the efficacy of the prescribed drugs, and the side effects and risk concerning discontinuation of the steroids. It is Also necessary to establish "Drug information and counseling day" in outpatient Department.

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【胶原蛋白病患者类固醇副作用经历与口服类固醇治疗不依从性的关系】。
目的:分析胶原蛋白病患者口服类固醇药物治疗依从性与不良反应经历的关系。方法:对佐贺医学院附属医院门诊的165例各种胶原蛋白疾病患者进行问卷调查。结果:94例患者(57%)有类固醇药物不依从史。49例(52.1%)患者意外忘记按医嘱服用类固醇,45例(47.9%)患者故意调整类固醇剂量或停止类固醇药物治疗。超过80%的患者经历了类固醇的副作用。出现以下一种或多种副作用的患者,骨质疏松、骨折、月经紊乱、月相脸、中枢性肥胖、脱发、痤疮样爆发、躁狂抑郁状态和失眠,有意调节或停止类固醇治疗。此外,未被医生和护士告知类固醇副作用的患者倾向于不依从组。结论:为了提高口服类固醇药物治疗的依从性,必须有意识地告知患者病情、处方药物的疗效、停药的副作用和风险。在门诊建立“药品信息咨询日”也是必要的。
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