坚持慢性药物治疗:在比利时也是一个常见的问题!

Journal de pharmacie de Belgique Pub Date : 2013-12-01
S Liekens, L Hulshagen, M Dethier, G Laekeman, V Foulon
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引用次数: 0

摘要

慢性疾病如哮喘、2型糖尿病、心力衰竭、艾滋病毒和癌症的药物依从性似乎是一个常见的问题。然而,关于使用吸入性皮质类固醇(ICS)、口服降糖药、心力衰竭药物、抗逆转录病毒药物或口服化疗的患者依从性的文献中,比利时的相关数据很少或没有。在鲁汶大学药学护理硕士论文的背景下,进行了一项定量研究,以确定比利时坚持慢性药物治疗的患病率。这项回顾性的横断面研究使用了一个包含区域药剂师协会(KLAV)的再填充数据的数据库。在与该协会有关联的603家药店中,所有50家提供艾滋病毒药物的药店都被选中。所选药房于2008年7月1日至2009年12月31日收集5种病状的调剂数据,即;哮喘、2型糖尿病、心力衰竭、艾滋病毒和癌症。采用药物补充依从性(MRA)法计算依从性(TT)。为了确定年龄、性别、药物类别和依从性之间是否存在关联,采用卡方检验。与其他患者相比,癌症患者的服药依从性最高(中位依从率= 88%)。此外,这是唯一一组中位依从率高于80%的设定限制。处方吸入皮质类固醇的患者的依从性最低(中位依从率= 38%)。超过50%的哮喘/慢性阻塞性肺病、心力衰竭和糖尿病患者被归类为“使用不足”。此外,结果显示哮喘患者的性别和依从性之间存在显著关联。在哮喘、2型糖尿病、心力衰竭和HIV患者中,年龄与依从性、药物类别与依从性之间存在显著关系。由于目前的研究有一定的局限性,因此应该谨慎对待结果。尽管如此,目前的研究表明,在比利时,慢性病患者,特别是哮喘患者的服药依从性也存在问题。
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[Adherence to chronic medication: also a frequent problem in Belgium!].

Medication adherence in chronic conditions such as asthma, type 2 diabetes, heart failure, HIV and cancer appears to be a frequent problem. However, the literature on adherence in patients who use inhaled corticosteroids (ICS), oral hypoglycemic agents, drugs for heart failure, antiretrovirals or oral chemotherapy, contains little or no relevant data for Belgium. In the context of a Master thesis in Pharmaceutical care at KU Leuven, a quantitative study was performed to determine the prevalence of adherence to chronic medication in Belgium. This retrospective, cross-sectional study used a database containing refill data of a regional pharmacists' association (KLAV). Out of the 603 pharmacies affiliated with this association, all 50 pharmacies where HIV medication was delivered, were selected. Dispensing data from the selected pharmacies were collected from 01/07/2008 to 31/12/2009 for five pathologies, i.e.; asthma, type 2 diabetes, heart failure, HIV and cancer. Adherence (TT) was calculated with the Medication Refill Adherence (MRA) method. In order to determine whether there were associations between age, gender, drug class and adherence, Chi-square tests were used. Compared with the other patients, cancer patients were the most adherent in taking their drugs (median adherence rate = 88%). In addition, this was the only group in which the median adherence rate was above the set limit of 80%. The patients who were prescribed inhaled corticosteroids were the least adherent (median adherence rate = 38%). More than 50% of patients with asthma/COPD, heart failure and diabetes were classified as "under-users". Furthermore, the results showed a significant association within asthma patients between gender and adherence. In asthma, type 2 diabetes, heart failure and HIV patients there was a significant relationship between age and adherence and drug class and adherence. As the current study has some limitations, the results should be handled with caution. Nevertheless, the current study shows that also in Belgium there is a problem with medication adherence in chronic conditions, especially in asthma patients.

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