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首页> 外文期刊>Journal of Clinical Epidemiology >Congruence between patient characteristics and interventions may partly explain medication adherence intervention effectiveness: an analysis of 190 randomized controlled trials from a Cochrane systematic review
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Congruence between patient characteristics and interventions may partly explain medication adherence intervention effectiveness: an analysis of 190 randomized controlled trials from a Cochrane systematic review

机译：患者特征与干预之间的一致性可能部分解释药物依从性干预效果：对来自Cochrane系统审查的190个随机对照试验的分析

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Abstract Objectives Due to the negative outcomes of medication nonadherence, interventions to improve adherence have been the focus of countless studies. The congruence between adherence-related patient characteristics and interventions may partly explain the variability of effectiveness in medication adherence studies. In their latest update of a Cochrane review reporting inconsistent effects of adherence interventions, the authors offered access to their database for subanalysis. We aimed to use this database to assess congruence between adherence-related patient characteristics and interventions and its association with intervention effects. Study Design and Setting We developed a congruence score consisting of six features related to inclusion criteria, patient characteristics at baseline, and intervention design. Two independent raters extracted and scored items from the 190 studies available in the Cochrane database. We correlated overall congruence score and individual features with intervention effects regarding adherence and clinical outcomes using KruskalWallis rank sum test and Fisher's exact test. Results Interrater reliability for newly extracted data was almost perfect with a Cohen's Kappa of 0.92 [95% confidence interval (CI)??.890.94; P ?P ??.003). Moreover, effective adherence interventions were significantly associated with improved clinical outcomes (odds ratio??.0; 95% CI??.112.0; P ?Conclusion The presence of only six studies that included nonadherent patients and the interdependency of this feature with the remaining five might preclude a conclusive assessment of congruence between patient characteristics and adherence interventions. In order to obtain clinical benefits from effective adherence interventions, we encourage researchers to focus on the inclusion of nonadherent patients.
机译：摘要目的是由于药物不正常的负面结果，改善遵守的干预措施是无数研究的重点。依赖相关患者特征和干预之间的一致性可能部分解释药物依从性研究中有效性的可变性。在他们的最新更新中的Cochrane审查报告遵守干预措施的不一致效果，提交人提供了对其数据库进行分析的数据库。我们旨在使用该数据库评估依赖相关患者特征和干预措施与干预效果之间的一致性。研究设计和环境我们开发了一致的分数，包括六种与纳入标准，基线患者特征有关的特征和干预设计。两个独立的评估者从Cochrane数据库中提供的190项研究中提取和评分项目。我们在使用Kruskalwallis等级和测试和Fisher的确切测试中关联了关于遵守和临床结果的干预效果的整体一致性分数和个体功能。结果新提取数据的Interrader可靠性几乎完美，Cohen的Kappa为0.92 [95％置信区间（CI）吗？。890.94; p？p ?? 003）。此外，有效的依从性干预与改善的临床结果有显着相关（odaber比率0; 0; 95％CI。112.0; P？结论仅存在六项研究，其中包括非正式患者和这个特征与剩余的相互依赖性五可能会阻止对患者特征和依从性干预之间的一致性的结论评估。为了从有效的依从性干预中获得临床效益，我们鼓励研究人员专注于包含非正职患者。

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