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Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study
BMC Family Practice ( IF 3.2 ) Pub Date : 2019-09-14 , DOI: 10.1186/s12875-019-1019-3
Cesar I. Fernandez-Lazaro , Juan M. García-González , David P. Adams , Diego Fernandez-Lazaro , Juan Mielgo-Ayuso , Alberto Caballero-Garcia , Francisca Moreno Racionero , Alfredo Córdova , Jose A. Miron-Canelo

Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence. Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

中文翻译:

初级保健中慢性病患者对治疗及相关因素的依从性:一项横断面研究

坚持治疗是一个公共卫生问题,在慢性疾病治疗中尤为重要。初级保健实践为有效治疗和管理这些疾病提供了理想的场所。这项研究的目的是评估初级保健机构中慢性病患者对治疗的依从性和相关因素。在西班牙初级保健中心对299名≥1慢性病和成年处方药的成年患者进行了横断面研究。Morisky-Green-Levine问卷用于通过面对面访谈评估药物依从性。使用世界卫生组织提出的多维模型,使用粗略和调整后的多元Logistic回归模型来分析与依从性相关的因素-社会和经济,医疗团队和与系统有关,与疾病有关,与治疗有关以及与患者有关的因素。坚持治疗的患者比例为55.5%。年龄较大(每10年调整后的优势比1.31,95%CI 1.01–1.70),用于药物补充的药房数量较少(0.65,95%CI 0.47–0.90),并且已收到完整的治疗信息(3.89,95%) CI 2.09–7.21),对药物疗程有足够的了解(4.17,95%CI 2.23–7.80)以及对生活质量的自我感知(2.17,95%CI 1.18–4.02)是与依从性相关的独立因素。在初级保健中对慢性病治疗的依从性仍然很低。通过量身定制的多方面干预措施来实现最佳的依从性水平,需要关注本研究中发现的多维因素,
更新日期:2019-09-14
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