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Abstract

Introduzione. L'indice di aderenza ha un ruolo fondamentale nel trattamento dei pazienti poichè influenza notevolmente l'efficacia di un trattamento terapeutico in termini di miglioramento della sopravvivenza globale, della speranza di vita, della qualití  della stessa e di riduzione dei costi sanitari. Esistono lacune nell'individuazione degli indicatori da utilizzare per valutare l'aderenza e le modalití  attraverso cui tali indicatori debbano essere adottati. L'obiettivo di questo lavoro è quello di individuare in letteratura gli indicatori di aderenza.

Metodo. Revisione sistematica della letteratura di tipo quantitativo effettuata seguendo il metodo PRISMA. La ricerca è stata condotta su: Cinhal-EBSCO, Medline-PUBMED e Scopus. Sono stati ricercati studi che misurassero l'aderenza dei pazienti al trattamento in lingua inglese e pubblicati dal 2010 al 2016. La selezione è stata effettuate utilizzando criteri di inclusione ed esclusione. La qualití  degli articoli è stata valutata con la NewCastle Ottawa Scale per gli studi osservazionali e con la Cochrane Collaboration Risk of Bias per gli studi sperimentali.

Risultati. Sono stati ritrovati in totale 7,368 articoli e di questi selezionati 15 (11 studi osservazionali, 4 RCT), per un totale di 1,396 pazienti. Gli indicatori individuati sono: strumenti self-report, conta pillola, tasso di ricarica del farmaco, misure continue, dosaggio dei metaboliti. Un paziente oncologico è considerato aderente al trattamento se assume una percentuale di farmaci ≥ 80% rispetto ai farmaci prescritti.

Discussione. Si ottiene una valutazione migliore di aderenza mediante l'utilizzo di più strumenti contemporaneamente. Gli indicatori oggettivi derivano dall'utilizzo dei metodi di misurazione diretta dell'aderenza, quelli soggettivi da quella indiretta. Parole chiave: self-management support, oral chemioterapy, measure adherence, measure compliance.

The Adherence's indicators of cancer patients to oral chemotherapy. A sistematic literature review.

ABSTRACT

Introduction. Adherence has a key role in treating patients as influences the effectiveness of therapeutic treatment for improving overall survival, life expectancy, quality of life and reducing healthcare costs. There are gaps in identifying indicators to be used to evaluate adherence and ways in which these indicators should be adopted. The aim of this paper is to identify adherence's indicators in literature.

Methods. Systematic review was carried out in, Cinhal-EBSCO, Medline-PUBMED and Scopus including studies of measure patient's adherence in English and published from 2010 to 2016. Inclusion and exclusion criteria were used. The quality of the articles was assessed with the NewCastle Ottawa Scale for observational studies and the Cochrane Collaboration Risk of Bias for experimental studies.

Results. Of the 7,368 papers initially retrieved, 15 met the inclusion criteria (11 observational studies, 4 RCTs), for a total of 1,396 patients. The indicators found are: self-report tools, pill counts, drug recharge rate, continuous measures, metabolic dosage. A patient is considered adherent to the treatment if he or she assumes a percentage of drugs ≥ 80% of the prescribed medications. Discussion. A better adherence rating is obtained by using multiple instruments at the same time. The objective indicators derive from the direct measurement methods of adherence, the subjective ones from the indirect. Key words: self-management support, oral chemioterapy, measure adherence, measure compliance.

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Come citare
Rega, M. L., Calabrese, C., Tortorella, P., De Waure, C., & Damiani, G. (2018). Gli indicatori di aderenza dei pazienti oncologici alla chemioterapia orale. Evidenze empiriche da una revisione sistematica della letteratura. PROFESSIONI INFERMIERISTICHE, 71(2). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/496
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