慢性病与药物依从性

MedicationAdherence:AKeyIssueforChronicDiseasesManagementOutline2DefinitionofMedicationAdherenceStatusofAdherenceinChronicDiseasesManagementImpactofNon-adherenceonDiseaseOutcomesandHealthcareCost3ADHERENCEPERSISTENCE%ofdosetakenasprescribedDaystakingmedicationTimingDosageFrequencyDurationDefinitionCramerJA,etal,ValueHealth.2008,11(1):44-7.doi:10.1111/j.1524-4733.2007.00213.x.Lowpersistentratesacross6chronicmedicationclasses4ARB=angiotensinIIreceptorblocker;OAB=overactivebladder.28%18%66%54%YeawJ,etal,JManagCarePharm.2009;15(9):728-40N=167,907DaysLow12-monthadherenceratesacross6chronicmedicationclasses537%61%60%72%66%35%0%20%40%60%80%100%1yearadherencerateARB=angiotensinIIreceptorblocker;OAB=overactivebladder.YeawJ,etal,JManagCarePharm.2009;15(9):728-406DiabetesHypertensionPooradherenceleadstopooroutcomesMedicationadherenceassociatedwithhospitalizationriskinDM/HTNpts.+:P0.05vs80%-100%adherencegroupSokolMC,etal,MedCare,2005,43:521-530Aretrospectivecohortobservation,137,277patients,age65y,Pooradherenceresultedinmorehealthcarecost7$290billion/yearavoidablemedicalspending13%totalhealthcareexpenditures$100billion/year,forexcesshospitalizations1/3-1/2Non-adherence1.ThinkingOutsidethePillbox:ASystem-wideApproachtoImprovingPatientMedicationAdherenceforChronicDisease,NEHI,Aug,2009,′e,AdherencetoLong-TermTherapies:EvidenceforAction,WorldHealthOrganization,2003.≈1/2indevelopedcountry1/2indevelopingcountryConclusion8Poormedicationadherencerateacrosschronicdiseases.Pooradherenceleadstopooroutcomesandmorehealthcarecosts.Medicationadherenceisakeyissueforchronicdiseasesmanagementtobeimprove.9Thanks