抑郁症患者药物治疗态度和依从性的影响因素研究

Influencing factors of compliance to drug treatment in patients with depression

目的评价抑郁症患者的药物治疗态度和药物治疗依从性,并分析依从性的影响因素。方法选取2018年7月至2020年3月在绍兴市第七人民医院就诊的抑郁症患者173例,收集患者一般情况和临床资料,药物治疗第4周时使用药物态度量表(DAI-10)、药物依从性评定量表(MARS)、Beck抑郁自评量表(BDI)对患者服药态度、服药依从性、抑郁程度进行评价。结果DAI-10评分在不同发作次数、BDI评分、病耻感、对抑郁症及药物了解程度、出现过明显药物不良反应、担心药物不良反应的抑郁症患者中比较差异均有统计学意义(均P<0.05),且发作次数≤2次、BDI评分轻中度者、无病耻感者、对抑郁症及药物知识了解多者、未出现过明显药物不良反应者、不担心药物不良反应者,DAI-10的评分较高。服药依从性好与依从性差的抑郁症患者受教育年限、发作次数、BDI评分、DAI-10评分、病耻感、对抑郁症及药物了解程度、是否存在明显药物不良反应、是否担心药物不良反应等方面比较差异均有统计学意义(均P<0.05)。logistic回归分析显示,对抑郁症及药物的了解程度、DAI-10评分是影响抑郁症患者服药依从性的独立因素(均P<0.05)。结论抑郁症患者药物治疗依从性欠佳,药物治疗态度、对抑郁症及药物了解程度是药物治疗依从性的主要影响因素,有必要采取措施改善抑郁症患者药物治疗依从性。

Objective To analyze the influencing factors of compliance to drug treatment in patients with depression.Methods A total of 173 patients with depression treated in Shaoxing Seventh People's Hospital from July 2018 to March 2020 were included in the study.The drug attitude inventory(DAI-10),medication adherence rating scale(MARS)and Beck depression inventory(BDI)were used to evaluate the attitude towards medication,drug treatment compliance and degree of depression of the patients at the 4th week,respectively.Results There were significant differences in DAI-10 scores among patients with different number of frequency of attack,BDI score,stigma,understanding of depression and drugs,occurrence of obvious drug side effects and worrying about drug side effects(P<0.05).The scores of DAI-10 were higher in patients with less than two episodes of depression,mild to moderate BDI score,without stigma,more knowledge about depression and drugs,without obvious adverse drug reactions,and without worrying about drug side effects.There were significant differences in MARS score among patients with different years of education,frequency of attack,BDI score,DAI-10 score,stigma,understanding of depression and drugs,occurrence of obvious drug side effects and worrying about drug side effects(P<0.05).Logistic regression analysis showed that DAI-10 score,understanding of depression and drugs were the independent influencing factors of MARS(P<0.05).Conclusion The medication adherence of depression patients is poor,drug attitude and understanding of depression and medication are the main influencing factors of medication adherence.It is necessary to take measures to improve medication adherence of depression patients.