摘要
目的:探究2型糖尿病患者用药依从轨迹及其影响因素,尤其是人格特质与用药依从的关系。方法:抽取北京市通州区和顺义区4个社区卫生服务中心的2型糖尿病患者作为研究对象,在基线、3个月、6个月、12个月时进行随访。采用中国大五人格量表简式版评估患者的人格特质,采用用药依从量表评估患者用药依从性。构建组基-轨迹模型探究患者的用药依从轨迹,采用重复测量方差分析描述各轨迹变化情况,应用有序多分类Logistic回归探究轨迹的影响因素。结果:共纳入患者671名。用药依从轨迹可分为3组:高-持续型(60.6%),中-增长型(35.3%),低-不变型(4.1%)。重复测量方差分析结果显示,高-持续型和中-增长型不同时间点的用药依从得分差异具有显著性(P=0.007,P<0.001)。有序多分类Logistic回归结果显示,病程(P=0.042,OR=1.053,95%CI:1.002~1.106)、是否为本地医保(P=0.028,OR=4.204,95%CI:1.169~15.120)、神经质得分(P=0.005,OR=0.966,95%CI:0.945~0.988)是2型糖尿病患者用药依从轨迹的影响因素。结论:2型糖尿病患者的用药依从轨迹可以分为3类,病程、是否为本地医保、神经质得分是用药依从轨迹的影响因素。在未来的管理实践中,要多关注病程长的患者,且将人格因素纳入考虑,重点关注神经质特质明显的患者。
OBJECTIVE To explore the trajectory of medication adherence and its influencing factors in patients with type 2 diabetes mellitus,especially the relationship between personality traits and medication adherence.METHODS Patients with type 2 diabetes mellitus in 4 community health service centers in Tongzhou District and Shunyi District of Beijing were selected as the subjects.They were followed up at baseline,3 months,6 months and 12 months.The personality traits of patients were evaluated based on the simplified version of the Chinese Big Five personality scale,and the medication adherence scale was used to evaluate the medication adherence of patients.Group-based trajectory model was used to explore the trajectory of medication adherence.Repeated measurement analysis of variance was used to describe the changes of trajectories,and ordinal multiple Logistic regression was used to explore the influencing factors of the trajectories.RESULTS 671 patients were included.The medication adherence trajectories could be divided into three groups:high-continuous(60.6%),medium-growth(35.3%)and low-constant(4.1%).The results of repeated measurement analysis of variance showed that there was significant difference in medication compliance scores between high-continuous type and medium-growth type at different time points(P=0.007,P<0.001).The results of ordinal multiple logistic regression showed that course of disease(P=0.042,OR=1.053,95%CI:1.002-1.106),whether having local insurance(P=0.028,OR=4.204,95%CI:1.169-15.120)and neuroticism(P=0.005,OR=0.966,95%CI:0.945-0.988)were the influencing factors of trajectories in patients with type 2 diabetes.CONCLUSION The medication adherence trajectories of patients with type 2 diabetes can be divided into 3 categories.Course of disease,whether having local insurance and neuroticism are the influencing factors.In the future,we should pay more attention to patients with long course of disease,take personality factors into account,and focus on patients with obvious neurotic characteristics.
作者
陈平
郭怡
吴一波
孙昕霙
CHEN Ping;GUO Yi;WU Yi-bo;SUN Xin-ying(Department of Social Medicine and Health Education,Peking University Health Science Center,Beijing 100191,China)
出处
《中国医院药学杂志》
CAS
北大核心
2022年第8期769-773,共5页
Chinese Journal of Hospital Pharmacy
基金
国家自然科学基金(编号:72174008)。
关键词
2型糖尿病
大五人格
用药依从性
纵向数据
组基-轨迹模型
type 2 diabetes
Big Five Personality theory
medication adherence
longitudinal study
group-based trajectory model
