摘要
目的调查社区共病患者服药依从性,探讨其影响因素,为社区医务人员制定相应的干预措施提供参考依据。方法于2016年5—8月,采用随机抽样方法抽取佛山市顺德区乐从社区卫生服务中心所管理的共病患者907例为调查对象,调查社会人口学资料和疾病相关资料,采用中文版8条目Morisky问卷(MMAS-8)调查服药依从性,采用健康状况调查量表(SF-36)中文版其中的总体健康条目评价患者自评健康状况,分析影响共病患者服药依从性的相关影响因素。结果 MMAS-8平均评分为(6.4±1.7)分,其中>6分(依从性好)495例(54.6%),≤6分(依从性差)412例(45.4%)。不同性别、年龄、婚姻状况、居住情况、文化程度、体质指数(BMI)、服药持续时间社区共病患者服药依从性比较,差异均无统计学意义(P>0.05);不同医疗付费方式、工作情况、家庭人均月收入、共病数量、服药种类、自评健康状况社区共病患者服药依从性比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,医疗付费方式[OR=1.384,95%CI(1.161,1.649)]、工作情况[OR=0.463,95%CI(0.324,0.661)]、共病数量[OR=1.771,95%CI(1.467,2.137)]和自评健康状况[OR=1.980,95%CI(1.517,2.583)]与社区共病患者服药依从性有回归关系(P<0.05)。结论社区共病患者服药依从性较差,医疗付费方式、在岗、共病数量多和自评健康状况差是其影响因素,应针对其影响因素和特点进行干预和管理。
Objective To investigate the medication adherence of community multimorbidity patients and explore the influencing factors,so as to provide reference for medical staff to formulate appropriate interventions. Methods Nine hundred and seven patients in Lecong Community Health Service Center in Shunde District of Foshan from May and August 2016 were selected by using random sampling method. We investigated its socio-demographic data and related information of diseases. The Chinese version of the 8-item Morisky Medication Adherence Scale（ MMAS-8） was used to survey the medication adherence,the overall health items of SF-36 scale was adopted to assess the self-assessed health status. And the factors associated with multimorbidity in the participants were analyzed. Results The average MMAS-8 score was（ 6. 4 ± 1. 7）. 495 cases（ 54. 6%）got more than 6 points,412 cases（ 45. 4%） less than or equal to 6. There were no significant differences in medication adherence among the patients with different gender,age,marital status,living conditions,educational attainment,BMI,and medication duration（ P〉0. 05）; there were significant differences in medication adherence among the patients with different medical payment methods, working situation, household monthly income per person, numbers of comorbidities, medication types,self-assessed health status（ P〈0. 05）. Multivariate Logistic regression analysis found that medication adherence was affected substantially by medical payment methods [OR = 1. 384, 95% CI（ 1. 161, 1. 649） ], working situation [OR= 0. 463,95% CI（ 0. 324,0. 661） ], numbers of comorbidities [OR = 1. 771,95% CI（ 1. 467,2. 137） ] and self-assessed health status [OR = 1. 980,95% CI（ 1. 517,2. 583） ]. Conclusion Poor medication adherence was found in the multimorbidity patients managed by Shunde Lecong Community Health Service Center of Foshan,which is mainly affected by methods for paying the medical expenses, employment status, increased comorbidities, and poor self-assesse
作者
王金明
林盛强
杨玉明
莫海韵
欧伟麟
欧文森
吴文林
杨志鹏
张曼
王家骥
WANG Jin-ming LIN Sheng-qiang YANG Yu-ming MO Hai-yun OU Wei-lin OU Wen-sen WU Wen-lin YANG Zhi-peng ZHANG Man WANG Jia-ji(School of Public Health, Guangzhou Medical University, Guangzhou 511436, China Lecong Community Health Service Center in Shunde District of Foshan, Foshan 528315, China)
出处
《中国全科医学》
CAS
北大核心
2017年第23期2827-2831,共5页
Chinese General Practice
基金
佛山市科技局自筹经费类科技计划项目(医学类科技攻关)(2016AB003373)
佛山市卫生和计划生育局医学科研课题(20170331)
关键词
共病现象
社区卫生服务
服药依从性
影响因素分析
Comorbidity
Community health services
Medication adherence
Root cause analysis
