非瓣膜性房颤老年患者华法林用药依从性及相关因素调查研究

Investigation on compliance and related factors of warfarin in elderly patients with non-valvular atrial fibrillation

目的研究非瓣膜性房颤老年患者华法林用药依从性及相关因素。方法选取2016年3月~2018年12月武汉亚洲心脏病医院收治的老年非瓣膜性房颤患者96例为研究对象,调查统计老年非瓣膜性房颤患者华法林用药依从性情况,分析影响老年非瓣膜性房颤患者的华法林用药依从性的相关因素。结果本研究共发放调查问卷96份,回收有效问卷82份,有效回收率为85.42%,其中用药依从性好者为43.90%。用药依从性好的患者与性别、文化程度、合并症种数、年龄、华法林抗凝知识问卷(WRKS)得分均有关(均P<0.05);而与婚姻状态、职业、饮酒史、吸烟史、合并用药种数等无关(P>0.05)。性别为男性(OR=1.661,95%CI:1.108,1.924,P=0.037)、文化程度为小学及以下(OR=2.512,95%CI:1.494,4.324,P=0.009)、合并症种数≥3种(OR=1.573,95%CI:0.616,1.234,P=0.026)、WRKS得分≤8分(OR=1.798,95%CI:1.103,3.506,P=0.017)是老年非瓣膜性房颤患者用药依从性的影响因素。结论老年非瓣膜性房颤患者华法林用药依从性较差,易受性别、文化程度、合并症种数、WRKS得分的影响,临床上应尽可能对上述因素引起重视,以提高老年非瓣膜性房颤患者华法林用药依从性。

Objective To study the compliance and related factors of Warfarin in elderly patients with non-valvular atrial fibrillation.Methods Ninety-six elderly patients with non-valvular atrial fibrillation admitted to Wuhan Asian Heart Hospital from March 2016 to December 2018 were selected as the research objects.The compliance of Warfarin in elderly patients with non-valvular atrial fibrillation was investigated and the related factor effecting the compliance of Warfarin in elderly patients with non-valvular atrial fibrillation was analyzed.Results A total of 96 questionnaires were sent out and 82 valid questionnaires were recovered.The effective recovery rate was 85.42%.Among them,43.90%of the patients had good drug compliance.Good drug compliance of patients was related to gender,education level,number of complications,age and WRKS scores(all P<0.05).However,there were no related to marital status,occupation,drinking history,smoking history and the number of combined drugs(P>0.05).The influencing factors of drug compliance in elderly patients with non-valvular atrial fibrillation were male(OR=1.661,95%CI:1.108,1.924,P=0.037),primary school education or below(OR=2.512,95%CI:1.494,4.324,P=0.009),number of complications≥3 types(OR=1.573,95%CI:0.616,1.234,P=0.026)and WRKS scores≤8 points(OR=1.798,95%CI:1.103,3.506,P=0.017).Conclusion Elderly patients with non-valvular atrial fibrillation have poor compliance with Warfarin.They are susceptible influenced by gender,education level,number of complicationsand WRKS scores.Clinical attention should be paid to the above factors as much as possible to improve the compliance of Warfarin in elderly patients with non-valvular atrial fibrillation.