北京市糖尿病患者服药依从性影响因素

Influencing factors of medication compliance among community diabetes patients in Beijing: a cross-sectional study

目的探究糖尿病患者服药依从性的影响因素,为提高糖尿病患者服药依从性水平提供依据。方法于2017年3—4月在北京市城市地区采用整群抽样方法,抽取2个行政区,在每个行政区各抽取3个社区,每个社区以卫生服务站为单位,对其管辖范围内的糖尿病患者就基本信息、糖尿病一般情况、自我管理知识和技能、自我管理行为、自我管理行为动机、自我效能等方面进行调查。使用单因素方差分析和logistic回归分析服药依从性的影响因素。结果调查对象为607例,平均年龄(64.8±8.4)岁,男女比例1:1.83,知识、技能、自我效能和动机得分分别为(47.2±14.8)、(62.8±14.2)、(74.3±18.0)、(61.7±18.1)分。服药依从性方面,服药遗忘率较高(47.1%)。服药依从性与自我效能(OR=1.012,95%CI=1.006～1.018)和病程长短(OR=1.046,95%CI=1.016～1.076)存在相关,自我效能得分越高、病程越长的患者服药依从性越好。结论提高自我效能对提高服药依从性具有积极意义。

Objective To explore influencing factors of medication compliance among community diabetes patients and to provide evidences for improving diabetes patients′ medication compliance. Methods We conducted a self-administered questionnaire survey among 607 type 2 diabetes mellitus patients selected with cluster sampling in 6 communities of 2 administrative regions in Beijing city during March to April,2017. We collected the patients′ information on demographics, general condition of the disease,self-management knowledge/skill/behavior/motivation,and self-efficiency using a selfdesigned questionnaire. Analysis of variance (ANOVA) and logistic regression were adopted to assess the correlation between self-efficiency and medication compliance. Results For all the participants,the average age was 64.8 ± 8.4 years and the male to female ratio was 1 : 1.83;the mean scores were 47.2 ± 14.8,62.8 ± 14.2,and 61.7 ± 18.1 for selfmanagement knowledge,skill,and motivation and the mean score was 74.3 ± 18.0 for self-efficacy. About a half (47.1%) of the participants reported ever forgetting to take the medicine. Medication compliance was positively correlated with selfefficacy (odds ratio [OR]= 1.012,95% confidence interval [95% CI]: 1.006-1.018) and duration of the disease (OR = 1.046, 95% CI: 1.016-1.076). Conclusion Self-efficacy promotion has positive impact on enhancing medication compliance among community type 2 diabetes mellitus patients.