社区干预对慢性乙型肝炎患者抗病毒治疗依从性的影响研究

Influence of Community Intervention on Compliance of Patients with Chronic Hepatitis B for Antiviral Therapy

目的探讨社区综合干预策略对慢性乙型肝炎(CHB)患者抗病毒治疗依从性的影响。方法选择2007年5月—2009年5月在明楼社区应用核苷(酸)类抗病毒药物治疗的CHB患者221例,随机分为干预组111例和对照组110例,对照组给予常规抗病毒药物治疗和健康教育,干预组在给予抗病毒药物治疗的基础上进行针对性的社区干预。干预1年后通过问卷方法对两组患者抗病毒治疗依从性进行调查以及不遵医的原因分析,并抽取部分不依从患者进行深度访谈。结果干预后两组遵医程度间差异有统计学意义(P<0.05);影响CHB患者治疗依从性的主要因素包括患者对疾病及药物的认识程度,患者的经济状况,医生和家属对用药的监督程度等。结论 CHB的治疗除常规抗病毒外辅以社区综合干预能提高患者的依从性,近期效果好。

Objective To explore the impact of community comprehensive intervention strategy on the antiviral treatment compliance of patients with chronic hepatitis B（CHB）.Methods Totally 221 CHB patients,who had received nucleoside analogous agents of antiviral medicine from May 2007 to May 2009 in Minglou community,were randomly divided as trial group（n=111） and control group（n=110）.The patients in the control group were given conventional antivirus medication and health education,and the patients in the trial group were given targeted community interventions additionally.After one year intervention,questionnaire survey was conducted among the patients about their antiviral treatment compliance,the reasons for non-compliance were analyzed,and a part of the non-compliant patients were interviewed.Results The degrees of compliance showed a statistical difference between the two groups after the intervention（P0.05）.The main factors influencing the treatment compliance of patients with CHB included the awareness on disease and drug,economic situation of patients,and supervision of medication by doctors and family members.Conclusion It can raise the compliance of the CHB patients to apply the community intervention comprehensively based on the conventional antiviral therapy,with a good short-term result.