摘要
背景社区管理可促进糖尿病患者的依从性行为,有利于维持更好的健康状态。已有研究大多集中于社区管理对糖尿病患者依从性的影响,国内外尚缺乏不同社区管理年限对糖尿病患者依从性影响的研究。目的了解2型糖尿病患者的依从性情况,探究社区管理年限对2型糖尿病患者依从性行为的影响。方法于2017年7—9月,选取2017-09-29前在上海市普陀区社区卫生服务中心建卡,并纳入社区管理的2型糖尿病患者15088例为研究对象,通过社区糖尿病患者管理系统获取患者的人口学资料、疾病相关信息、治疗情况和依从性情况。采用Logistic回归分析社区管理年限对糖尿病患者依从性行为的影响。结果2型糖尿病患者的平均社区管理年限为(4.05±2.46)年,主要治疗方式是口服降糖药物(10462例,69.34%),其中,12156例(80.57%)患者糖化血红蛋白(HbA1c)控制达标,7621例(50.51%)患者体质指数(BMI)控制良好,5855例(38.81%)患者腰围控制差(中心性肥胖),9589例(63.55%)患者血压控制良好。2型糖尿病患者的服药依从率为95.55%(13107/13717),不同年龄、病程、治疗方式、BMI控制情况、社区管理年限的2型糖尿病患者服药依从率比较,差异有统计学意义(P<0.05);饮食控制率为87.19%(13155/15088),不同性别、年龄、病程、治疗方式、BMI控制情况、社区管理年限的2型糖尿病患者饮食控制率比较,差异有统计学意义(P<0.05);规律运动率为47.45%(7159/15088),不同年龄、病程、社区管理年限的2型糖尿病患者规律运动率比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,调整性别、年龄、病程、BMI和治疗方式后,中长期管理(1~4年)是规律运动行为〔OR=1.415,95%CI(1.225,1.637),P<0.05〕的促进因素;长期管理(>4年)是服药依从行为〔OR=2.925,95%CI(2.109,4.022),P<0.05〕、饮食控制行为〔OR=2.051,95%CI(1.689,2.481),P<0.05〕、规律运动行为〔OR=2.596,95%CI(2.239
Background Community-based management can improve the treatment compliance to obtain a better outcome in diabete patients.Available related studies mostly focus on the impact of community-based management on the treatment compliance of diabete patients.But the association of treatment compliance and years of community-based management has rarely been studied.Objective To explore the treatment compliance and its association with years of community-based management in type 2 diabetes.Methods From July to September 2017,15088 type 2 diabetes who had applied for a health card and received community-based management as of September 29,2017 were recruited from Shanghai Putuo Community Health Service Center.Data regarding demographics and disease-related information,treatment and treatment compliance were obtained through the community-based diabetes management system.Logistic regression was used to examine the association between years of community-based management and treatment compliance.Results The average duration of community-based management was(4.05±2.46)years,with oral hypoglycemic drugs as the major intervention(10462 patients,69.34%).Among them,12156(80.57%)met the target HbA1c level,7621(50.51%)had satisfied BMI control,9589(63.55%)had good blood pressure control,but 5855(38.81%)with central obesity did not meet the target waist circumference.The medication compliance was 95.55%(13107/13717).The medication compliance varied significantly by age,course of type 2 diabetes,treatment,BMI control status and years of community-based management(P<0.05).The diet control rate was 87.19%(13155/15088),which varied significantly according to sex,age,course of type 2 diabetes,treatment,BMI control status and years of community-based management(P<0.05).The regular exercise rate was 47.45%(7159/15088).The regular exercise rate differed significantly by age,course of type 2 diabetes,and years of community-based management(P<0.05).After adjusting for sex,age,course of type 2 diabetes,BMI and treatment,Logistic regression an
作者
邓诗姣
于杰
于海星
吴春香
DENG Shijiao;YU Jie;YU Haixing;WU Chunxiang(School of Public Health,Fudan University,Shanghai 200032,China;Shanghai Putuo District Center for Disease Control and Prevention,Shanghai 200333,China)
出处
《中国全科医学》
CAS
北大核心
2020年第34期4381-4385,4393,共6页
Chinese General Practice
关键词
糖尿病
2型
社区卫生服务
依从性
社区管理年限
Diabetes mellitus,type 2
Community health services
Compliance
Years of community-based management
