慢性病管理依从问题研究的困境及“破局”思路

慢性病是影响人群健康及国家社会经济发展的重大公共卫生问题,慢性病管理是现阶段许多国家的重要议题,管理方案依从不佳是慢性病管理过程中的“卡脖子”问题。本文描述了慢性病管理过程与管理方案依从的嵌套模型,梳理了当前国内外慢性病管理过程中依从问题的切片式研究态势,并从本体论、认识论和方法论视角提出应对慢性病管理依从不佳问题的新思路,为构建慢性病管理依从促进、维持系统,应对我国慢性病管理的困境助力。

Dilemmas and thoughts on solutions of adherence to chronic disease management

Chronic diseases are a major public concern resulting in substantial social and economic consequences globally. The suboptimal adherence to strategies of chronic disease management is the “bottleneck” issue that should be addressed across countries. This paper describes the nested theoretical model integrating the process of chronic disease management and adherence to management strategies derived from both empirical and theoretical evidence, summarizes the arguments on the “salami slicing” actions adopted by researchers in adherence promotion studies, and proposes our thoughts on solutions of adherence to management strategies via the lens of ontology, epistemology, and methodology. Efforts in this paper may imply future researchers to develop a system to promote and maintain adherence to management strategies among patients with chronic diseases, and facilitate the chronic disease management in China.