用药不依从对冠心病结局的影响。一篇批判性综述

摘要(中文译文)

为评估药物依从性对冠状动脉疾病和充血性心力衰竭患者或高危人群的患病率和死亡率的影响，对已发表的文献进行了批判性综述。本文总结了21篇符合纳入标准且涉及药物依从性与患病率和死亡率关系的原创研究文章。未发现专门检验提高依从性干预措施对冠心病结局影响的临床试验。在12项比较依从者与非依从者住院率和死亡率的研究中，有7项显示药物依从性与结局之间存在显著关系。3项研究表明，对安慰剂的依从与结局改善相关，提示依从行为可能是更好预后的标志，或对冠心病患者具有保护作用。需要进一步研究以确定依从行为是否可以被传授，以及提高依从性的策略是否能改善冠心病的结局。

Abstract

A critical review of published literature was performed to assess the impact of medication adherence on morbidity and mortality among patients with or at risk for coronary artery disease and congestive heart failure. Twenty-one original research articles that met our inclusion criteria and related medication adherence to morbidity and mortality are summarized. No clinical trials that specifically tested the impact of a compliance-enhancing intervention on outcome in coronary heart disease were identified. Among 12 studies that compared hospitalization rates and mortality between adherers and nonadherers, 7 showed a significant relationship between medication adherence and outcomes. Three studies showed that adherence to placebo was associated with improved outcomes, suggesting that adherent behavior may be a marker of better prognosis or confers a protective effect on patients with coronary heart disease. Further study is necessary to determine whether adherent behavior can be taught and whether compliance-enhancing strategies improve outcomes in coronary heart disease.

如何引用