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The role of patient preferences in adherence to treatment in chronic disease: a narrative review

机译：患者偏好在慢性疾病中依赖于治疗的作用：叙事综述

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ABSTRACT Adherence to prescribed medication is important to the management of all diseases, especially those of chronic nature. Drug effectiveness is substantially compromised by therapy nonadherence. We reviewed the available evidences on the impact of patient preferences for therapy on adherence to a prescribed treatment in chronic diseases requiring long-term treatment. A search on PubMed retrieved 699 publications, leading to a selection of 12 publications: 6 on osteoporosis, 2 on moderate-to-severe asthma, 1 on type 1 diabetes, 1 on type 2 diabetes, 1 on kidney transplantation, and 1 on atrial fibrillation. Overall, 8 studies found a positive association between patient preference and adherence to therapy, while the others found no association. In general, overall adherence was considered to be high in the published studies. The reasons for a positive association included reduced dosing frequency, route of administration, lower costs, and favorable safety profile, which is related to the diverse nature of the pathology and its type and duration of treatment. A literature review suggests that achieving good adherence and persistence to therapy requires evaluation of patient preferences. In a period of increasingly limited resources, more effort is warranted to promote better adherence to therapy, especially when patients must self-manage their disease in the long term. Our results further highlight that insufficient attention has been given to the relationship between patient preference and adherence and point out the complex nature of adherence and the need for adequate patient education. More efforts are also needed to better understand the entity of cost savings for payers for specific treatments and the link with patient preference.
机译：摘要对规定药物的依从性对所有疾病的管理都很重要，尤其是慢性自然的疾病。药物效果基本上通过治疗不正常损害。我们审查了有关患者偏好对治疗的影响的可用证据，以遵守需要长期治疗的慢性疾病中的规定治疗。在PubMed检索的699个出版物上搜索，导致选择12个出版物：6对骨质疏松症，2型对1型糖尿病，1型糖尿病，1型糖尿病，1对肾移植1次，1对1纤维化。总体而言，8项研究发现患者偏好和依从治疗之间的正相关，而其他研究则没有任何关联。一般而言，在公布的研究中被认为总体依从性很高。积极关联的原因包括降低给药频率，给药途径，降低成本和有利的安全性曲线，这与病理学的不同性质及其类型和治疗持续时间有关。文献综述表明，实现对治疗的良好依从性和持久性需要评估患者偏好。在日益有限的资源期间，有权促进更好地遵守治疗的努力，特别是当患者必须长期自我管理疾病时。我们的结果进一步强调，对患者偏好和遵守的关系，并指出了坚持性的复杂性和适合足够患者教育的关系。还需要更多的努力来更好地了解支付者的成本节省的实体，以获得特定治疗和与患者偏好的联系。

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