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首页> 外文期刊>Patient Preference and Adherence >High adherence level to artemisinin-based combination therapies in rural settlement 11 years after their introduction in the health system, Nanoro, Burkina Faso
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High adherence level to artemisinin-based combination therapies in rural settlement 11 years after their introduction in the health system, Nanoro, Burkina Faso

机译：布基纳法索Nanoro引入卫生系统11年后，对农村地区基于青蒿素的联合疗法的依从性很高

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Purpose: In 2005, Burkina Faso changed its first-line treatment for uncomplicated malaria from chloroquine to artemisinin-based combination therapies (ACTs). Patient adherence to ACTs regimen is a keystone to achieve the expected therapeutic outcome and prevent the emergence and spread of parasite resistance. Eleven years after the introduction of ACTs in the health system, this study aimed to measure adherence level of patients in rural settlement and investigate the determinants of nonadherence. Patients and methods: The study was carried out at public peripheral health facilities from May 2017 to August 2017 in Nanoro health district, Burkina Faso. An electronic semi-structured questionnaire was used for data collection from patients with an ACT prescription at their medical consultation exit visit and during home visit at day 5±2. Adherence level was measured through self-report and pill counts. Logistic regression was performed to identify factors for nonadherence. Results: The analysis was conducted on 199 outpatients who received ACT as prescription. About 92.5% of ACT prescriptions included artemether-lumefantrine tablets. Adherence level was measured in 97.0% of included patients at day 5±2. Of these, 86.0% were classified as “complete adherent” and 14.0% as “nonadherent”. In univariate analysis, patients/caregivers who considered that affordability of ACTs was easy seemed to be less adherent to the treatment regimen (OR: 0.26; 95% CI: 0.07–0.70). In univariate and multivariable analyses, patients/caregivers who did not receive advices from health care workers (HCWs) were more likely to be nonadherent to the prescribed ACTs (adjusted OR: 3.21; 95% CI: 1.13–9.12). Conclusion: This study demonstrates that majority of those who get an ACT prescription comply with the recommended regimen. This emphasizes that in rural settings where ACTs are provided free of charge or at a subsidized price, patient adherence to ACTs is high, thus minimizing the risk of subtherapeutic concentrations of the drug in blood which is known to increase resistance and susceptibility to new infections. Therefore, to address the problem of patient nonadherence, strategy to strengthen communication between HCWs and patients should be given greater consideration.
机译：目的：2005年，布基纳法索将其对一例复杂疟疾的一线治疗从氯喹改为基于青蒿素的联合疗法（ACTs）。患者遵守ACTs方案是实现预期治疗结果并防止寄生虫抗药性出现和扩散的基石。在将ACTs引入卫生系统11年之后，本研究旨在测量农村居民区患者的依从性水平，并调查不依从性的决定因素。患者和方法：该研究于2017年5月至2017年8月在布基纳法索的Nanoro卫生区的公共外围卫生机构进行。在接受医疗咨询的出诊时和第5±2天的家庭访视期间，使用电子半结构式问卷调查收集了ACT处方患者的数据。通过自我报告和药丸计数来测量粘附水平。进行逻辑回归以识别不坚持的因素。结果：对199名接受ACT处方的门诊病人进行了分析。 ACT处方中约有92.5％包含蒿甲醚-左啡肽片。在第5±2天，对97.0％的纳入患者进行了粘附水平测量。其中，86.0％被归类为“完全粘附”，14.0％被列为“不粘附”。在单变量分析中，认为ACTs的负担能力较容易的患者/护理人员似乎对治疗方案的依从性较差（OR：0.26; 95％CI：0.07–0.70）。在单变量和多变量分析中，未获得医护人员（HCW）指导的患者/护理人员更有可能不遵守规定的ACT（调整后的OR：3.21; 95％CI：1.13-9.12）。结论：这项研究表明，大多数接受ACT处方的人都遵循推荐的治疗方案。这强调了在免费或以补贴价格提供ACT的农村地区，患者对ACT的依从性很高，因此将血液中药物的亚治疗浓度降低的风险降到最低，众所周知，血液中亚治疗浓度的药物会增加耐药性和对新感染的易感性。因此，为了解决患者不依从的问题，应更加考虑加强医务工作者与患者之间沟通的策略。

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