患者报告的与用药有关的问题、用药依从性以及口服抗癌药的长期浪费情况。

IF 1.6 4区 医学 Q3 PHARMACOLOGY & PHARMACY European journal of hospital pharmacy : science and practice Pub Date : 2024-07-17 DOI:10.1136/ejhpharm-2024-004205
Patricia M L A van den Bemt, Margriet Y Blijham, Laura Ten Broek, Jacqueline G Hugtenburg, Bart P H Pouls, Job F M van Boven, Charlotte L Bekker, Bart van den Bemt, Liset van Dijk
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引用次数: 0

摘要

目的:接受口服抗癌药物治疗的患者经常会遇到与用药相关的问题(MRPs),这可能会导致患者不坚持用药和药物浪费。大多数报告这些经历的研究都是横断面设计。我们的研究旨在探讨患者报告的口服抗癌药物相关问题、依从性和浪费情况:我们采用半结构式问卷对口服抗癌药物(主要是酪氨酸激酶抑制剂、(抗)激素疗法、嘧啶拮抗剂)的患者进行了为期 4 个月的前瞻性纵向定量访谈研究。在获得知情同意后,2022 年 3 月至 12 月期间,来自荷兰两所大学医疗中心的患者被纳入调查范围。共进行了四次访谈,每次访谈间隔一个月。所有访谈都进行了录音,然后将数据输入电子病例报告表。主要结果是每轮访谈中每位患者的 MRP 平均数量。次要结果是至少有一次 MRP 的患者比例、MRP 的类型、认为的不依从性、药物浪费(包括一般浪费和专门针对抗癌药物的浪费)、抗癌药物浪费的成本以及患者提到的与药物浪费相关的因素。数据分析采用了描述性统计方法:40名患者的平均(标清)年龄为64(9)岁;43%为男性。在第一次访谈中,每位患者的平均 MRP 数为 2.1,在第二次、第三次和第四次访谈中分别为 1.2、1.0 和 0.9。药物不良反应是最常报告的 MRP 类型(第一次访谈中有 30 名患者(75%),最后一次访谈中有 19 名患者(65%))。无意不遵医嘱的情况时有发生,尤其是在第一次访谈中。所有访谈中都提到了频繁换药和相关的药物浪费现象:结论:许多使用口服抗癌药治疗的患者都报告了 MRP,而且随着时间的推移,这一数字仍然很大。
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Patient reported medication-related problems, adherence and waste of oral anticancer medication over time.

Objectives: Patients on oral anticancer therapy regularly experience medication-related problems (MRPs), potentially leading to non-adherence and medication waste. Most studies reporting these experiences have cross-sectional designs. The aim of our study was to explore patient reported MRPs, adherence and waste of oral anticancer medication over time.

Methods: A prospective longitudinal quantitative interview study with 4 months follow-up was performed among patients on oral anticancer medication (mainly tyrosine kinase inhibitors, (anti)hormonal therapy, pyrimidine antagonists) using a semi-structured questionnaire. Patients from two Dutch university medical centres were included from March to December 2022 after informed consent was given. Four interviews were performed with 1 month in between. All interviews were audiotaped, after which the data were entered into an electronic case report form. The primary outcome was the mean number of MRPs per patient per interview round. Secondary outcomes were the proportion of patients with at least one MRP, types of MRPs, perceived non-adherence, medication waste (both in general and specifically for anticancer medication), costs of anticancer medication waste, and factors associated with medication waste as mentioned by the patient. Descriptive statistics were used to analyse the data.

Results: Forty patients were included with a mean (SD) age of 64 (9) years; 43% were male. The mean number of MRPs per patient was 2.1 in the first interview and 1.2, 1.0 and 0.9 in the second, third and fourth interviews, respectively. Adverse drug reactions were the most frequently reported type of MRPs (30 (75%) patients in the first interview and 19 (65%) in the last interview). Unintentional non-adherence was regularly reported, especially in the first interview. Medication changes were frequent and associated medication waste was mentioned in all interviews.

Conclusions: Many patients using oral anticancer treatment report MRPs and this number remains substantial over time.

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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
104
审稿时长
6-12 weeks
期刊介绍: European Journal of Hospital Pharmacy (EJHP) offers a high quality, peer-reviewed platform for the publication of practical and innovative research which aims to strengthen the profile and professional status of hospital pharmacists. EJHP is committed to being the leading journal on all aspects of hospital pharmacy, thereby advancing the science, practice and profession of hospital pharmacy. The journal aims to become a major source for education and inspiration to improve practice and the standard of patient care in hospitals and related institutions worldwide. EJHP is the only official journal of the European Association of Hospital Pharmacists.
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