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薬理と治療
- Author: 天野宏一1
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Abstract
Articles on medication adherence to oral disease modifying anti-rheumatic drugs(DMARDs) among patients with rheumatoid arthritis were extracted from research available on the Pub-Med database from its inception to January 2013. Ninety six articles from PubMed were included if they addressed adherence in patient with rheumatoid arthritis and included a clear definition of the methods used to determine adherence and the determinants used. This literature review is limited to 7 articles with a patient count of ≧100 and an observation period of 1 year in longitudinal study. Adherence rate to oral DMARDs was suboptimal, ranging from 30% to 69%. Improving adherence to DMARDs therapy could dramatically improve the efficacy of drug therapy. No consistent risk factors were identified for nonadherence to oral DMARDs or other prescriptions;however, there was some evidence for self-efficacy, patient-health-care-provider relationships, patient beliefs about medications, patient support for educational intervention programs, and patient age as factors affecting adherence. Besides addressing practical barriers, healthcare providers should be sensitive to patients’ personal beliefs that may affect adherence, and should discuss with their patients any concerns that they raise about prescription medicines. Because beliefs and concerns are modifiable, there is hope that adherence can be improved.
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