我院门诊患者用药依从性及其影响因素的调查分析

Investigation and Analysis of Influential Factors of Outpatient Medication Compliance in Our Hospital

目的:提高门诊患者的用药依从性。方法:随机选择1 000例门诊患者,采用自拟问卷进行调查,评判其用药依从性,对依从性差的患者进一步进行表现形式和影响因素调查,据此提出门诊药师的干预措施。结果:共发出1 000份问卷并全部回收,有效回收率100.00%。1 000例门诊患者中,依从性差的患者共计426例,比例为42.60%,其中过早停止用药311例,占73.00%;漏服218例,占51.17%;服药时间错误179例,占42.02%;超剂量及剂量不足86例,占20.19%;随意换药46例,占10.80%;拒绝用药11例,占2.58%。依从性差的影响因素中,患者自身因素261例,占61.27%;不良反应因素143例,占33.57%;治疗方案因素89例,占20.89%;药品因素174例,占40.85%;医师和药师因素146例,占34.27%;社会因素71例,占16.67%。结论:用药依从性差是门诊患者常见现象,其表现类型呈现多元性,受多方面因素影响,应引起门诊药师的足够重视。建议门诊药师采取针对性、系统性的干预措施,如简化治疗方案、提供全程化标准化药学服务、提高自身专业技能、加强高风险药品监管等,以提高门诊患者用药依从性,促进合理用药。

OBJECTIVE：To improve the medication compliance in the outpatients.METHODS：1 000 outpatients were randomly selected and investigated by self-designed medication compliance questionnaire.The medication compliance was evaluated,and types and influential factors of poor compliance were analyzed to put forward intervention measure.RESULTS：A total of 1 000 questionnaires were sent out and all were returned,with recovery rate of 100.00%.There were 426 patients with poor medication compliance among 1 000 outpatients,accounting for 42.60% ：311 patients stopped taking medicines untimely,accounting for 73.00%;218 cases missed medication,accounting for 51.17%;179 cases were wrong medication time,accounting for 42.02%;86 cases were overdosing and underdosing,accounting for 20.19%;46 cases were casual drug change,accounting for 10.80%;11 cases were refusing medication,accounting for 2.58%.The influential factors of poor compliance included patient＇s own factors in 261 cases（61.27%）,adverse drug reactions in 143 cases（33.57%）,complicated treatment regimens in 89 cases（20.89%）,drug factors in 174 cases（40.85%）,physician and pharmacist factor in 146 cases（34.27%）and social factors in 71 cases（16.67%）.CONCLUSIONS：Poor medication compliance is common phenomenon in outpatients.Its performance type shows diversity and is affected by various factors,which should be paid enough attention by outpatient pharmacists.It is suggested to outpatient pharmacists that to adopt targeted and systematic intervention measures to improve the compliance of outpatients and rational drug use,i.g.simplifying therapeutic scheme,providing whole-coursing standard pharmaceutical care,improving professional skills and strengthening the management of high risk drug.