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背景:海地一家自服药结核病诊所。 目的:探讨在发展中国家,是否只有采用直接观察下的治疗才能帮助解决服药顺从性问题。 设计:把病人随机分为3组:A组:从药品监察器取药品,并在监察记录上给予忠告;B组:从药品监察器取药品,在记录上未得到忠告;C组:从简单的容器中取药。 结果:在前11周,监察记录良好是已经预料到的,治疗丢失者很少(P<0.01),并且在后9个月中,顺从性很好(P<0.01)。研究表明,在监察记录上给予忠告可使放弃治疗者减少约一半。 结论:本研究提示,在不能全程实行直接观察下治疗的地区,对自服药的药品监察是有效的,特别是在农村地区。其用处为:1)明确地鉴定出治疗顺从性差的病人;2)减少诊所对服药监察记录良好,居住远离诊所病人的访视频度;3)把监察记录告知病人,以改善治疗顺从性;4)当发现不合作时,可以延长其治疗期。
Background: A self-medication tuberculosis clinic in Haiti. PURPOSE: To investigate whether it is only in the developing countries that treatment with direct observation can help solve the problem of compliance with medication. Design: Patients were randomized into 3 groups: Group A: Drugs were taken from the drug monitor and advice was given on the surveillance records; Group B: Drugs were taken from the drug monitor without any advice on the record; Group C: Take the medicine in the container. RESULTS: In the first 11 weeks, good surveillance records were previously anticipated, with few treatment losers (P <0.01) and good compliance (P <0.01) in the last 9 months. Studies show that giving advice on the surveillance record can reduce the number of those who give up treatment by about half. CONCLUSIONS: This study suggests that drug surveillance of self-medication may be effective in areas where direct observation can not be practiced throughout the country, particularly in rural areas. Its usefulness is: 1) Clearly identify patients with poor compliance; 2) Reduce the number of visits to the clinic where the medical records are well maintained by the clinic; 3) Keep the patient informed of surveillance records to improve treatment compliance; 4 ) When found to be uncooperative, you can extend the treatment period.