摘要
目的耐药肺结核(MDR-TB)患者的服药依从性问题已引起高度重视,本研究采用倾向性评分法(PSM)探讨疾病感知与服药依从性的相关性。方法选取2019年6月-2022年10月丽水市中医院结核病科收治的172例MDR-TB患者,依据Morisky服药依从性量表(MMAS-8)分成依从性良好组(103例)和依从性较差组(69例)。比较组间相关资料和简易疾病感知问卷(BIPQ)量表评分,采用logistic回归分析研究MDR-TB患者服药依从性的影响因素。PSM法按照1∶1的比例进行组间均衡匹配,比较PSM匹配后组间资料。分析PSM匹配前后MDR-TB患者MMAS-8、BIPQ量表评分的相关性。结果PSM匹配前,依从性良好组年龄<60岁、病程<2年、高中及以上文化水平、家庭月收入≥6000元、家人督导服药的比例高于依从性较差组(均P<0.05),医疗自费、有药物不良反应的比例和BIPQ量表评分低于依从性较差组(均P<0.05)。年龄、病程、文化水平、家庭经济水平、医疗支付方式、药物不良反应、BIPQ量表评分是MDR-TB患者服药依从性的独立影响因素(均P<0.05)。PSM匹配48对,依从性良好组BIPQ量表评分低于依从性较差组[(35.17±5.78)分vs.(43.22±6.25)分,t=6.551,P<0.05]。PSM匹配前后BIPQ、MMAS-8量表评分均呈负相关关系(r=-0.674、-0.574,均P<0.05)。结论MDR-TB患者服药依从性的影响因素较多,其疾病感知水平与服药依从性呈负相关。
Objective The issue of medication adherence in patients with multi drug-resistance tuberculosis(MDR-TB)has received much attention.This study used propensity score matching(PSM)to explore the relationship between disease perception and medication adherence.Methods From June 2019 to October 2022,172 patients with MDR-TB admitted to the tuberculosis department of Lishui Hospital of Traditional Chinese Medicine,and were divided into a good compliance group(n=103)and a poor compliance group(n=69)according to the Morisky medication adherence scale(MMAS-8).The relevant data between groups and the scores of the brief illness perception questionnaire(BIPQ)were compared,and the factors influencing MDR-TB patients'medication adherence were analyzed logistically.The PSM method performs balanced 1∶1 matching between groups and compares data between groups after PSM matching.To analyze the correlation between MMAS-8 and BIPQ scores in MDR-TB patients before and after PSM matching.Results Before PSM matching,the proportion of the good compliance group with age<60 years,disease duration<2 years,education level of high school or above,family monthly income≥6000 yuan,and family supervised medication use was higher than that of the poor compliance group(all P<0.05);the proportion of medical expenses,adverse drug reactions,and BIPQ score were lower in the poor compliance group(all P<0.05).Age,disease course,level of education,family economic level,method of medical payment,adverse drug reactions and BIPQ scale scores were independent predictors of drug adherence in MDR-TB patients(all P<0.05).After 48 pairs of PSM were successfully matched,the BIPQ of the good compliance group was still significantly lower than that of the poor compliance group[(35.17±5.78)points vs.(43.22±6.25)points,t=6.551,P<0.05].There was a moderate negative correlation between BIPQ and MMAS-8 scores in MDR-TB patients before and after PSM matching(r=-0.674,-0.574,all P<0.05).Conclusion There are many factors influencing drug adherence in MDR-TB patients
作者
郑珍慧
江巧敏
张尊敬
ZHENG Zhenhui;JIANG Qiaomin;ZHANG Zunjing(Tuberculosis Department,Lishui Hospital of Traditional Chinese Medicine,Lishui,Zhejiang 323000,China)
出处
《中华全科医学》
2023年第11期1872-1875,共4页
Chinese Journal of General Practice
基金
浙江省中医药科技计划项目(2022ZB399)。
关键词
耐药肺结核
倾向性评分法
疾病感知
服药依从性
相关性
Drug-resistant pulmonary tuberculosis
Propensity score matching
Disease perception
Medication adherence
Relevance
