社区残疾人药学服务需求现状及差异性研究

Status of and Individual-specific Differences in Pharmaceutical Service Needs among Community-dwelling People with Disability

背景残疾人群是多种疾病的高发人群,目前对于其医疗服务需求的研究多集中在定期体检、上门服务、康复指导等方面,而针对其药学服务需求的研究相对较少。目的了解社区残疾人的药学服务需求,基于基本人口学特征、社会经济地位、残疾类别和残疾等级探讨其药学服务差异。方法于2017年11—12月,采用单纯随机抽样法在上海市某街道的在册残疾人中抽取230例进行问卷调查。主要内容包括:残疾人的基本人口学特征(性别、年龄、婚姻状况)、社会经济地位(文化程度、工作状态、家庭人均月收入)、残疾类别与残疾等级、药学服务需求(需求内容、需求来源、需求程度)。结果共回收有效问卷226份(98.3%)。残疾人的药学服务需求内容排在前2位的为"用法用量及疗程"(73.0%,165/226)、"适应证和禁忌证"(51.3%,116/226);需求来源主要为医生(85.4%,193/226);需求程度为非常/比较需要者占48.2%(109/226)。在需求内容上,不同工作状态者对"药品说明书解读"服务的需求率比较,差异有统计学意义(P<0.05);不同家庭人均月收入者对"用法用量及疗程"服务的需求率比较,差异有统计学意义(P<0.05)。在需求来源上,不同年龄、工作状态、残疾等级者对由医生提供药学服务的需求率比较,差异有统计学意义(P<0.05);不同年龄者对通过媒体获得药学服务的需求率比较,差异有统计学意义(P<0.05)。在需求程度上,不同文化程度、工作状态、残疾类别、残疾等级者对药学服务的需求程度比较,差异有统计学意义(P<0.05)。结论不同情况残疾人的药学服务需求内容差异性不大,但需求来源、需求程度差异性较大,尤其是需求程度。社区药师应采用多种形式对残疾人开展用药宣教和个性化药学服务。

Background People with disabilities are very susceptible to many diseases.Most of available studies have discussed medical services needs in this group,such as regular check-up,home-based care,and rehabilitation guidance,but relatively few have explored their pharmaceutical service needs.Objective To explore the needs of pharmaceutical services in community-dwelling people with disabilities,and analyze the differences in this group by basic demographic characteristics,socio-economic status,type and severity of disability.Methods From November to December 2017,a survey was conducted in a simple random sample of 230 registered people with disabilities from a street of Shanghai.A self-designed questionnaire was used in the survey to collect the following data:basic demographic characteristics(gender,age,marital status),socioeconomic status(educational level,retired or not,household monthly income per capita),type and severity of disability,pharmacy services(components and grade of pharmacy service needs,and providers satisfying such needs).Results Altogether,226 cases(98.3%)responded effectively to the survey.The top two demands were"usage and dosage"(73.0%,165/226)and"indications and contraindications"(51.3%,116/226).The rate of demanding"interpretation of drug package inserts"service differed significantly by the prevalence of retirement(P<0.05).And the rate of needing services of interpreting"usage,dosage and course of treatment"varied significantly by household monthly income per capita(P<0.05).The main provider satisfying pharmaceutical service demand was"doctor"(85.4%,193/226).The rate of needing a doctor to satisfy such demands changed obviously by age,prevalence of retirement,and severity of disability(P<0.05).The rate of satisfying such demands through social media varied significantly by age(P<0.05).Pharmacy services were highly/relatively demanded in 48.2%(109/226)of the respondents.The grade of demanding of such services differed significantly by educational level,prevalence of retirement,type and severity of disability(P<0.05).Conclusion Community-dwelling people with disabilities with different characteristics showed great differences in providers in demand for satisfying needed pharmaceutical services,and even greater differences in the grade of pharmaceutical services in demand,but showed similar components of such services in demand.So community pharmacists should deliver targeted medication education and pharmaceutical services in accordance with personal conditions.