摘要
目的为提高糖尿病患者用药依从性提供参考。方法随机抽取上海市金山区居民健康信息系统中朱泾镇5个村居的713例在册管理居家糖尿病患者,对其进行问卷调查、体格检查和生化检查,按Morisky-Green测评表评估患者的用药依从性。采用有序累积概率Logistic回归模型分析糖尿病患者用药依从性的影响因素。结果713例糖尿病患者中,男女比例为1∶1.34,男女糖尿病患者的职业、婚姻状况、文化程度、吸烟情况、饮食习惯均有显著差异(P<0.001);男性糖尿病患者腰围和舒张压均显著高于女性患者(P<0.05),收缩压、三酰甘油、总胆固醇、高密度脂蛋白胆固醇、血清胰岛素水平均显著低于女性患者(P<0.01)。糖尿病患者用药依从性好468例(65.64%),且不同性别患者服药依从性差异显著(P=0.0035)。用药依从性不同糖尿病患者的职业、居住情况、医保类型、饮食习惯、均衡饮食、TG水平、是否皮下注射胰岛素、血糖控制情况、是否发生低血糖、是否患心血管疾病情况均有显著差异(P<0.05)。多因素分析结果显示,职业、医保类型、饮食习惯、皮下胰岛素注射、患心血管疾病与用药依从性相关联(P<0.05)。结论上海市金山区朱泾镇居家糖尿病患者用药依从性良好,应强化健康教育,提高患者依从服药的健康信念,完善医疗保障制度,以提升其用药依从性。
Objective To provide a reference for improving medication compliance of diabetic patients.Methods A total of 713 registered and managed home-based diabetic patients in five villages and neighborhood committees of Zhujing Town were randomly selected from the Health Information System of Jinshan District Residents in Shanghai for questionnaire survey,physical examination and biochemical examination,and their medication compliance was evaluated according to the Morisky-Green assessment form.Logistic regression model with ordered cumulative probability was used to analyze the influencing factors of medication compliance in diabetic patients.Results Among 713 diabetic patients,the ratio of male to female was 1∶1.34.There were significant differences between male and female diabetic patients in occupation,marital status,education level,smoking status and eating habits(P<0.001).The waist circumference(WC)and diastolic blood pressure(DBP)of male diabetic patients were significantly higher than those of female diabetic patients(P<0.05),while the systolic blood pressure(SBP),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and serum insulin(SI)level of male diabetic patients were significantly lower than those of female diabetic patients(P<0.01).A total of 468 cases(65.64%)of diabetic patients had good medication compliance,and there were significant differences in the medication compliance among patients with different genders(P=0.0035).There were significant differences in the occupation,living conditions,medical insurance type,dietary habits and balanced diet,TG level,whether insulin was injected subcutaneously,blood sugar control,whether hypoglycemia occurred,and whether cardiovascular disease occurred among diabetic patients with different medication compliance(P<0.05).The results of multivariate analysis showed that occupation,medical insurance type,dietary habits,subcutaneous insulin injection,and cardiovascular disease were associated with medication compliance(P<0.05).Conclusion The medication compliance of home-based diabetic patients in Zhujing Town of Jinshan District in Shanghai is good.It is necessary to strengthen health education,improve patients'health belief in medication compliance,and improve the medical security system to improve patients'medication compliance.
作者
冒长青
高晓
聂莲莲
江雁
沈卫华
郭澄
MAO Changqing;GAO Xiao;NIE Lianian;JIANG Yan;SHEN Weihua;GUO Cheng(Jinshan Branch of Shanghai Sixth People′s Hospital,Shanghai,China 201599;Zouping People′s Hospital,Binzhou,Shandong,China 256200;Zhujing Community Health Service Center of Jinshan District,Shanghai,China 201599;Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,China 200233)
出处
《中国药业》
CAS
2023年第21期30-34,共5页
China Pharmaceuticals
基金
上海市卫生健康委员会科研项目[20224Y0202]
上海市金山区卫生健康系统第四周期“优秀青年人才”培养计划[JSYQ201908]
2020年度上海市金山区医药卫生类科技创新资金项目[2020-3-33]。
关键词
居家糖尿病患者
用药依从性
影响因素
药学服务
home-based diabetic patients
medication compliance
influencing factors
pharmaceutical care