摘要
目的通过分析影响四川地区慢性乙型肝炎患者抗病毒治疗依从性的因素,探讨提高患者治疗依从性的策略。方法选择2011年4月-2012年4月在四川大学华西医院接受核苷(酸)类似物抗病毒治疗的324例慢性乙型肝炎患者作为研究对象。采用问卷调查的方法,对患者一般情况、心理状态、文化程度、经济情况、疾病认知情况、抗病毒疗效、服药持续性等相关因素进行分析,评估这些因素对患者治疗依从性的影响。结果 324例患者中能够完全遵照医嘱者78例(24.07%),不能完全依从者246例(75.93%)。心理状态良好者132例(40.74%),其中依从性良好者54例;心理负担较重者192例(59.26%),其中依从性良好者24例。初中及以上学历204例(62.96%),依从性良好者72例;初中以下学历者120例(37.04%),依从性良好者仅6例。不同心理状态、文化程度的患者依从率差异有统计学意义。患者经济状况、年龄差异对于依从性也有一定影响。结论慢性乙型肝炎患者对抗病毒治疗的依从性与心理状态、文化程度者及经济状况密切相关。改善患者医疗费用偿付能力,对患者进行疾病认知教育以及减少社会歧视等措施有助于提高患者治疗依从性。
Objective To analyze the factors influencing compliance of antiviral therapy in patients with chronic hepatitis B （CHB） in Sichuan, so as to improve the treatment compliance of patients. Methods A total of 324 patients who took one or more NUCs between April 2011 and April 2012 were enrolled. All patients were asked to complete a structured, self-administered questionnaire with items addressing patients＇ mental state, educational background, personal economic conditions, disease cognitive, etc. The adherence to the therapy of the patients＇ were accessed by their treating clinicians. Results There were 78 cases （24.07%） in 324 complied with the doctor＇s order completely, and 205 cases （75.93%） were reported suboptimal adherence; in 132 patients with good psychological state during treatment, 45 of them could completely comply with the doctor＇s order; while in 192 patients with psychological problems, only 20 of them achieved optimal adherence （P=0.016）. There was statistically significant difference in the adherence between patients with different educational background. Compliance rate of 204 cases with junior high school or above education degree was higher than that of 72 eases with lower level of education （35.29% and 5.00%, P=0.012）.The economic conditions and age of the patient also had a relationship with the medication compliance. Conclusions The CHB patients＇ mental state and educational background are closely related with the adherence to antiviral therapy. Psychological support and patient education appear important to improve the ongoing adherence.
出处
《华西医学》
CAS
2013年第10期1555-1558,共4页
West China Medical Journal
基金
四川省卫生厅科研基金(110423)~~
关键词
慢性乙型肝炎
抗病毒治疗
依从性
Chronic hepatitis B
Antiviral therapy
Medication compliance
