IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Adam J Mackridge, Eifiona M Wood, Dyfrig A Hughes
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引用次数: 0

摘要

背景:服药依从性不佳是影响治疗效果的一个主要决定因素。在治疗长期疾病的处方药中,有三分之一到一半没有按计划服用,其原因是多方面的。改善服药依从性应能优化治疗效果。目的:确定有效且易于实施的以患者为中心的干预措施,以改善服药依从性,为改善健康状况的最佳实践提供参考:2022年5月11日,对Medline、CINAHL和EMBASE中2013年1月11日以来新增的出版物进行了检索,并对与Nieuwlaat的2014年Cochrane综述相关的引文进行了检索。我们对实证研究的荟萃分析和系统综述进行了总综述,以确定并描述可改善用药依从性的干预措施。对有效干预措施的实施潜力进行了评估:结果:改善用药依从性的策略具有共同的主题。共确定了 15 篇综述和荟萃分析,并将干预措施分为八类。其中包括利用药剂师提供干预;提供面对面的干预;使用复合制剂;提供提醒和提示机制;对个人依从率给予反馈;促进积极习惯的养成;使用加强自我管理和积极行为的策略;以及同时使用干预措施:根据系统综述或荟萃分析的证据,有几种易于实施的干预方法具有明显的效果。然而,由于该领域的证据基础多种多样,而且许多研究存在严重的偏倚风险,因此需要进一步开展工作,以了解不同干预措施的比较价值及其对以患者为导向的结果的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service.

Background: Suboptimal medication adherence is a major determinant of treatment outcome. Between a third and a half of prescribed medicines for long-term conditions are not taken as intended, the reasons for which are numerous and multifaceted. Improving medication adherence should optimise therapeutic outcomes.

Aim: To identify effective and readily implementable patient-focused interventions for improving medicines adherence that can inform best practice to improve health outcomes.

Method: Medline, CINAHL and EMBASE were searched on 11 May 2022 for publications added since 11 January 2013, along with citation searches linked to Nieuwlaat's 2014 Cochrane review. An umbrella review was undertaken of meta-analyses and systematic reviews of empirical research to identify and describe interventions that improve medication adherence. Effective interventions were assessed for their implementation potential.

Results: Strategies to improve medication adherence follow common themes. Fifteen reviews and meta-analyses were identified, and interventions were grouped into eight types. These included using pharmacists to provide interventions; providing face to face interventions; using combination formulations; providing reminders and prompting mechanisms; giving feedback on individual adherence rates; promoting positive habits; using strategies to enhance self-management and positive behaviours; and using interventions in parallel.

Conclusion: There are several readily implementable intervention approaches with demonstrable effectiveness based on systematic review or meta-analysis evidence. However, owing to the diverse evidence base in this field, and the significant risk of bias in many studies, further work is needed to understand the comparative value of different interventions and their impact on patient-oriented outcomes.

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来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
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