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提高炎症性肠病(IBD)患者的药物依从性:一项基于证据的叙述性综述。

Improving Medication Adherence Levels in Inflammatory Bowel Disease (IBD) Patients: A Narrative Evidence-Based Review.

作者信息

Amiesimaka Obreniokibo Ibifubara, Aluzaite Kristina, Braund Rhiannon, Schultz Michael

机构信息

Gastroenterology Research Unit, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand.

出版信息

Patient Prefer Adherence. 2024 Apr 20;18:905-916. doi: 10.2147/PPA.S383304. eCollection 2024.

Abstract

Inflammatory bowel disease (IBD) management is typified by a long-term medication regimen which can comprise multiple medications prescribed in different combinations, doses, frequencies, and with various administration routes. This complexity can make medication adherence (MA) - patients taking their medications per the prescription - for patients with IBD a challenge. The research corpus contains diverse interventions aimed at improving MA in patients with IBD. Therefore, to condense the evidenced strategies for ease of reference, this narrative evidence-based review broadly outlines the patient-level interventions reported. The interventions are grouped as educational, behavioural, cognitive-behavioural, and multicomponent. They, however, present mixed results as to their efficacy at improving MA, with those employing combined approaches being the most promising. This reflects the reality that MA is impacted by multiple factors encompassing those pertaining to the patient, disease, therapy, patients' socioeconomic status, and health system. Hence, the most ideal interventions would likely be multifaceted patient-level interventions alongside policy/system-level strategies, to maximise the potential for successfully improving patients' MA. These findings might have been impacted by the heterogeneity of the studies in terms of the method of MA assessment, duration of interventions, and more besides.

摘要

炎症性肠病(IBD)的管理以长期药物治疗方案为典型特征,该方案可能包含多种以不同组合、剂量、频率及各种给药途径开具的药物。这种复杂性使得炎症性肠病患者的药物依从性(即患者按处方服药)成为一项挑战。该研究语料库包含旨在提高炎症性肠病患者药物依从性的多种干预措施。因此,为了浓缩这些有证据支持的策略以便于参考,本基于叙述性证据的综述大致概述了所报告的患者层面的干预措施。这些干预措施分为教育性、行为性、认知行为性和多成分干预。然而,它们在提高药物依从性方面的疗效呈现出混合结果,采用综合方法的干预措施最具前景。这反映了一个现实,即药物依从性受到多种因素的影响,这些因素包括与患者、疾病、治疗、患者社会经济状况及卫生系统相关的因素。因此,最理想的干预措施可能是多层面的患者层面干预措施以及政策/系统层面的策略,以最大限度地提高成功改善患者药物依从性的可能性。这些研究结果可能受到了研究在药物依从性评估方法、干预持续时间等方面的异质性的影响。

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