在抑郁症治疗过程中,患者对坚持用药的障碍和促进因素的认识:定性研究。

IF 3 Q1 PRIMARY HEALTH CARE
Yuki Meng, Christopher Chiu, Mamta Kapoor, Shelly-Anne Li, Navaldeep Kaur, Patricia Marr, Debbie Kwan, Kori Leblanc, Catherine Ji, Christine Papoushek
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引用次数: 0

摘要

背景:抑郁症影响着全球约 2.8 亿人,是导致残疾的主要原因之一。尽管可以选择有效的药物治疗,但仍有 50%的患者在 6 个月内过早停用抗抑郁药物。我们试图从患者的角度了解他们对抗抑郁药物的需求和期望:确定并描述影响成年患者坚持抗抑郁药物治疗的因素和障碍,并探讨患者在开始或继续抗抑郁药物治疗方面的教育需求:在加拿大多伦多的一家城市初级保健诊所,对在研究招募后 3 个月内开具抗抑郁药处方的成年抑郁症患者进行了个人半结构式访谈,从而开展了定性描述研究。共对 13 名参与者进行了访谈。对访谈进行了记录并逐字转录,以便进行归纳式主题分析:结果:出现了六个主题:抗抑郁药的安全性和有效性、对抑郁症及其管理的理解、用药、治疗抑郁症的医疗经验以及社会影响和人际关系。妨碍患者坚持用药的因素包括抗抑郁药的不良反应、对非药物疗法的偏好、治疗效果的不确定性以及社会耻辱感。与此相反,抗抑郁药物的积极反应、对复发的恐惧、提醒辅助工具、固定的作息时间以及病人与医护人员之间的信任关系则是坚持治疗的有利因素。参与者希望获得可靠、循证和个性化的教育信息,这些信息可通过口头、书面和数字形式提供,以支持坚持服用抗抑郁药:为了克服已发现的障碍,教育策略应让患者及其处方医生共同参与,以确定患者的特定需求和治疗目标,共同参与决策,并保持持续的跟踪,以支持患者坚持服用抗抑郁药。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study.

Background: Depression affects approximately 280 million individuals globally and it is a leading cause of disability. Despite effective medication options, 50% of patients prematurely discontinue antidepressants within 6 months. We sought to understand patients' perspectives regarding their needs and expectations related to antidepressants.

Objectives: To identify and describe enablers and barriers that influence adult patients' medication adherence in depression treatment and to explore patients' educational needs on initiating or continuing antidepressant therapy.

Methods: Qualitative descriptive study was conducted using individual, semi-structured interviews of adult patients with depression who were prescribed an antidepressant within 3 months of study recruitment at an urban primary care clinic in Toronto, Canada. Thirteen participants were interviewed. Interviews were recorded and transcribed verbatim for inductive thematic analysis.

Results: Six themes emerged: safety and effectiveness of antidepressant, understanding of depression and its management, medication administration, healthcare experiences in the treatment of depression, and social influences and relationships. Barriers to adherence included adverse effects of antidepressants, preference for non-pharmacological therapies, uncertainty about therapeutic effects, and social stigma. In contrast, enablers were positive responses from antidepressants, fear of relapse, reminder aids, established routine, and a trusting patient-provider relationship. Participants desired access to reliable, evidence-based, and personalized educational information delivered through verbal, written, and digital formats to support antidepressant adherence.

Conclusion: To overcome the identified barriers, educational strategies should involve both patients and their prescribers to identify patient-specific needs and treatment goals, engage in shared decision-making, and maintain consistent follow-up to support antidepressant adherence.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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