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Why is greater medication adherence associated with better outcomes

机译：为什么更大的药物依从性会带来更好的结果

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Background Previous studies found an association of greater adherence to placebo medication with better outcomes. The present study tested whether this association was explained by any of the following factors: 1) adherence to other medications, 2) healthcare behaviors, 3) disease risk, or 4) predicted degree of adherence. Data included information on more than 800 risk factors from 27,347 subjects in two randomized controlled trials of hormone therapy in the Women's Health Initiative. Results Greater adherence to placebo was not associated with colon cancer but was substantially and significantly associated with several diverse outcomes: death, myocardial infarction, stroke, and breast cancer. Adherence to hormone therapy was only weakly associated with outcomes. The WHI risk factors only poorly predicted degree of adherence, R2 < 4%. No underlying factors accounted for the association between placebo adherence and outcome. Conclusion The results suggest that adherence to placebo is a marker for important risk factors that were not measured by WHI. Once identified these risk factors may be used to increase the validity of observational studies of medical treatment by reducing unmeasured confounding.
机译：背景先前的研究发现，对安慰剂药物的依从性更高且预后更好。本研究测试此关联是否由以下任何因素解释：1）坚持使用其他药物，2）保健行为，3）疾病风险或4）预测的坚持程度。数据包括“妇女健康倡议”中两项激素治疗随机对照试验中来自27,347名受试者的800多种危险因素的信息。结果对安慰剂的更大依从性与结肠癌无关，但与多种不同的结果有实质性显着关联：死亡，心肌梗塞，中风和乳腺癌。坚持激素疗法与预后之间的关系很小。 WHI的危险因素仅差地预测了依从性，R2 <4％。没有潜在因素解释安慰剂依从性和结果之间的关联。结论结果表明，坚持安慰剂是重要危险因素的标志物，而WHI并不能测量这些危险因素。一旦确定了这些危险因素，就可以通过减少无法衡量的混杂因素来提高药物治疗观察性研究的有效性。

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