门诊老年抑郁症患者服药依从性的影响因素分析

Factors associated with medication adherence among elderly outpatients with depressive disorder

目的调查门诊老年抑郁症患者的服药依从性状况并探讨其影响因素。方法采用一般资料调查表、服药信念量表、Morisky服药依从问卷,对北京市某三级甲等精神病专科医院的135例门诊老年抑郁症患者进行调查,采用多元有序Ordinal回归对患者服药依从性的影响因素进行分析。结果门诊老年抑郁症患者服药完全依从率仅有37.8%,回归提示复发次数、人均家庭月收入、合并焦虑及服药相关信念是服药依从性的影响因素(P<0.05)。结论老年抑郁症患者服药依从性不容乐观,应特别关注多次复发、人均家庭月收入较高、不合并焦虑的患者,并针对其服药相关信念给予干预和指导,对提高老年抑郁症患者的服药依从性具有重要意义。

Objective To investigate the status of medication adherence among elderly patients with depressive disorder and analyze its potential influencing factors. Methods A sample of 135 older adults with depressive disorder were recruited from an outpatient department. Adherence to antidepressant was assessed by the Morisky Medication Adherence Measure（MMAM）,and beliefs about antidepressant were assessed by the Beliefs about Medication Questionnaire（BMQ）. Sociodemographic and illness variables were also examined. Multiple ordinal regression was utilized to analyze influencing factors of medication adherence. Results High antidepressant adherence was only reported in 37.8% participants. Multiply ordinal regression showed that number of prior episode of depression,average family income,comorbidity anxiety and beliefs about medication were significant influencing factors of medica tion adherence（P〈0.05）. Conclusion The medication adherence behavior is unsatisfactory among patients with geriatric depression. More attention should be focused on patients with recurrent depression,relatively high level of family income,single depression. There is a need to establish accessible education programs to correct erroneous beliefs to improve their medication adherence.