糖尿病患者依从性对血糖控制的影响

Effect of medication adherence on blood glucose control in patients with diabetes mellitus

目的:探讨患者用药依从性、自我管理能力和接受糖尿病教育对糖尿病患者血糖控制的影响。方法:采用自行设计的调查问卷,收集上海市第十人民医院崇明分院内分泌专家门诊就诊的259例2型糖尿病患者的一般人口学信息、病史资料、血糖监测情况、糖尿病教育经历等信息。采用Morisky用药依从性评估法分析患者的用药依从性,应用χ2检验对数据进行统计分析,分析患者一般信息与用药依从性的关系,以及用药依从性或患者自我管理能力与血糖达标的关系。结果:共发放问卷259份,回收有效问卷230份,有效回收率为88.8%。230名患者中,122人(53.04%)用药依从性好,108人(46.96%)用药依从性不佳。平均糖化血红蛋白(HbA1c)值为(9.54±2.72)%。血糖达标的有131人(56.96%),未达标的99人(43.04%)。不吸烟、不喝酒的患者用药依从性较好(P<0.05),但吸烟和喝酒对血糖达标率影响不大。规律性血糖监测和接受糖尿病教育患者的血糖达标率显著高于未规律性检测血糖和未接受糖尿病教育的患者(P<0.05)。结论:患者用药依从性受诸多因素不同程度的影响,规律性监测血糖和对健康指导的有效服从有助于患者血糖控制。

Objective：To explore the effects of medication adherence,self-management ability of patients and diabetes education on blood glucose control in diabetic patients.Methods：General demographic information,medical history,blood glucose monitoring information,medical education on diabetes mellitus were collected from 259 patients with type 2 diabetes mellitus,who sought medical care in the expert outpatient department,Chongming Branch of Shanghai Tenth People＇s Hospital by using the self-designed questionnaire.Medication adherence of the diabetic patients was analyzed by Morisky medication adherence method.The obtained data was statistically analyzed by chi-square test.The relationship between general information and medication adherence,and the relationship between medication adherence or patient self-management ability and target-achieving of blood glucose standards were analyzed in the study.Results：Two hundred and fifty-nine copies of questionnaire were issued to the patients,and 230 valid questionnaires were retrieved,with an effective recovery rate of 88.8%.Of the 230 patients,122（53.04%）had good medication adherence and 108（46.96%）had poor adherence.The average level of glycosylated hemoglobin（HbA1 c）was（9.54±2.72）%.131 cases（56.96%）met the set blood glucose standards but 99 cases（43.04%）failed to meet.The patients without smoking or alcoholism displayed better medication adherence（P0.05）.However,smoking and alcoholism had little effect on the rate of reaching the set blood glucose standards.The rate of reaching the set blood glucose standards of patients with regular blood glucose monitoring and diabetes education was significantly higher than that of the patients without regular blood glucose monitoring and diabetes education（P0.05）.Conclusion：Medication adherence of patients was affected by many factors.Regular monitoring of blood glucose and effective obedience to health guidance could help patients to control blood glucose.