摘要
目的 探讨糖尿病患者服药依从性的影响因素,为糖尿病健康管理工作提供参考。方法 选取2017年7月1日至2021年6月30日在三明市尤溪县糖尿病健康管理中心平台登记注册的糖尿病患者为研究对象,随访收集一般人口学特征、服药情况、不良反应等信息,采用Stata 16.0统计软件利用广义估计方程(generalized estimating equation,GEE)分析服药依从性的影响因素,并分析患者使用胰岛素与户籍地、不同地区患者的使用胰岛素与随访次数间的交互作用对服药依从性的影响。结果 共纳入9 373例患者的161 432条随访记录。多因素GEE分析结果显示,随访次数多(OR=0.976,95%CI:0.972~0.981);与文盲或半文盲相比,小学(OR=0.863,95%CI:0.775~0.962)和初中(OR=0.864,95%CI:0.762~0.981)教育程度;与门诊随访相比,家庭随访(OR=0.833,95%CI:0.757~0.916)和电话随访(OR=0.878,95%CI:0.795~0.969);使用胰岛素(OR=0.393,95%CI:0.334~0.463)的糖尿病患者服药依从性更好,差异均有统计学意义(P<0.05,P<0.01)。职业状况为就业或退休前曾就业(OR=1.139,95%CI:1.018~1.274)、户籍为农村(OR=1.297,95%CI:1.185~1.419)的糖尿病患者服药依从性更差,差异均有统计学意义(P<0.05,P<0.01)。校正混杂因素后,交互作用分析结果显示,胰岛素使用和户籍地对糖尿病患者服药依从性存在交互作用(OR=1.425,95%CI:1.029~1.972),差异有统计学意义(P<0.05);农村地区患者的随访次数与胰岛素使用对糖尿病患者服药依从性存在交互作用(OR=1.040,95%CI:1.020~1.061),差异有统计学意义(P<0.05)。结论 在糖尿病健康管理服务中,应重点关注低学历、就业或退休前曾就业和农村地区的患者。
Objective To explore the influencing factors of the medicine compliance of patients with diabetes mellitus,and provide the reference for the health management of diabetes mellitus. Methods Diabetic patients registered in the platform of Youxi County Diabetes Health Management Center in Sanming city from July 1,2017 to June 30,2021 were selected as the subjects,the general demographic characteristics,medication,adverse reactions and other information were collected by following up. The generalized estimating equation(GEE) was used to analyze the influencing factors of medication compliance,and the interaction of household registration place,insulin use,and follow-up times on medication compliance was analyzed. The used software was Stata16.0. Results The study included 9 373 patients with 161 432 following up records. Multivariate GEE analysis results showed that more following up times(OR=0.976,95%CI:0.972-0.981);primary school(OR=0.863,95%CI:0.775-0.962) and junior high school(OR =0.864,95% CI:0.762-0.981) education levels as compared with illiterate or semi-illiterate;as compared with outpatient follow-up,home follow-up(OR=0.833,95%CI:0.757-0.916) and telephone follow-up(OR=0.878,95%CI:0.795-0.969);and insulin use(OR=0.393,95%CI:0.334-0.463) had better medication compliance(P<0.05). The diabetic patients with occupational status of employment/employment before retirement(OR=1.139,95%CI:1.018-1.274) and household registration of rural areas(OR=1.297,95%CI:1.185-1.419) had worse medication compliance(P<0.05). After adjusting the confounding factors, the interaction analysis showed that there was the interaction between insulin use and household registration on medication compliance in diabetic patients(OR=1.425,95%CI:1.029-1.972,P<0.05);and there was the interaction between insulin use or follow-up times in rural patients and medication compliance(OR=1.040,95%CI:1.020-1.061,P<0.05). Conclusion In diabetes health management services,it should pay attention to people with low education,employment or pre-retirement
作者
何雪
徐陆欣怡
任俊名
罗银
段媛媛
崔丹
HE Xue;XU Lu-xin-yi;REN Jun-ming;LUO Yin;DUAN Yuan-yuan;CUI Dan(School of Public Health,Wuhan University,Wuhan,Hubei Province 430071,China;Wuhan University Global Health Institute,Wuhan,Hubei Province 430072,China;不详)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2023年第2期117-121,共5页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
糖尿病
服药依从性
纵向数据
广义估计方程
Diabetes mellitus
Medicine compliance
Longitudinal data
Generalized estimating equation
