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首页> 外文期刊>British Journal of Dermatology >Impact of glucocorticoid-induced adverse events on adherence in patients receiving long-term systemic glucocorticoid therapy.
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Impact of glucocorticoid-induced adverse events on adherence in patients receiving long-term systemic glucocorticoid therapy.

机译：接受长期全身糖皮质激素治疗的患者中糖皮质激素引起的不良事件对依从性的影响。

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BACKGROUND: Factors influencing adherence to long-term (i.e. >/= 3 months) systemic glucocorticoid therapy are poorly understood. OBJECTIVE: To evaluate the relationship between glucocorticoid-induced adverse events and therapeutic adherence in patients on long-term glucocorticoid treatment. METHODS: A cross-sectional survey was conducted in three departments of dermatology/internal medicine between April and September 2008. Patients were asked to provide data regarding symptoms they attributed to glucocorticoids, and adherence to treatment was measured using the four-item Morisky-Green adherence scale. Logistic regression analyses were used to assess the association between reported adverse events and adherence to glucocorticoids. RESULTS: A total of 255 questionnaires were completed and analysed [women 78%; median age 48 years (interquartile range (IQR) 34-65); connective tissue diseases 59%; median duration of treatment 24 months (IQR 8-72); median daily dose 10 mg (IQR 6-20)]. Among these 255 patients, 199 (78%) reported themselves as 'good adherents' and 56 (22%) as 'poor adherents' to treatment. Poor adherence was associated with younger age [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95-0.99, per increasing year; P < 0.01], presence of glucocorticoid-induced epigastralgia (OR 4.02, 95% CI 2.00-8.09; P < 0.01) and presence of glucocorticoid-induced morphological changes (OR 2.49, 95% CI 1.19-5.21; P = 0.02). Moreover, patients with poor adherence were likely to report concomitantly poor adherence to dietary advice associated with glucocorticoid therapy (OR 2.44, 95% CI 1.12-5.26; P = 0.02). CONCLUSIONS: As with other chronic therapies, the presence of glucocorticoid-induced adverse events is associated with an altered self-reported adherence to glucocorticoids. Patients who report epigastric pain or morphological changes that they associate with glucocorticoid therapy are particularly at risk of poor adherence. Adherence to dietary advice associated with glucocorticoid therapy may be an indirect measure of treatment adherence.
机译：背景：影响长期（即> / = 3个月）全身性糖皮质激素治疗依从性的因素了解甚少。目的：评估长期接受糖皮质激素治疗的患者中糖皮质激素引起的不良事件与治疗依从性之间的关系。方法：2008年4月至2008年9月在三个皮肤科/内科部门进行了横断面调查。要求患者提供其归因于糖皮质激素的症状的数据，并使用四项Morisky-Green测定对治疗的依从性遵守量表。 Logistic回归分析用于评估报告的不良事件和糖皮质激素依从性之间的关联。结果：共完成255份问卷调查并进行了分析[妇女占78％;中位年龄48岁（四分位间距（IQR）34-65）;结缔组织疾病59％;中位治疗时间24个月（IQR 8-72）;每日平均剂量10毫克（IQR 6-20）]。在这255名患者中，有199名（78％）称自己为“良好依从者”，而56名（22％）则称自己为“不良依从者”。依从性差与年龄的增长[比值比（OR）为0.97，95％置信区间（CI）为0.95-0.99，每增加一年; P <0.01]，糖皮质激素诱发的上腹痛的存在（OR 4.02，95％CI 2.00-8.09; P <0.01）和糖皮质激素诱发的形态变化的存在（OR 2.49，95％CI 1.19-5.21; P = 0.02）。此外，依从性差的患者很可能会报告依从性差，与糖皮质激素治疗相关的饮食建议（OR 2.44，95％CI 1.12-5.26; P = 0.02）。结论：与其他慢性疗法一样，糖皮质激素引起的不良事件的发生与自我报告的糖皮质激素依从性改变有关。报告与糖皮质激素治疗相关的上腹痛或形态改变的患者特别容易出现依从性差的风险。坚持与糖皮质激素治疗有关的饮食建议可能是治疗依从性的间接指标。

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