粤北地区缺血性脑卒中患者抗血小板药物院外用药依从性动态研究及其相关因素分析

Study on the Compliance of Antiplatelet Drugs with Non-hospital Medications and Analysis of Related Factors in Patients with Ischemic Stroke in Northern Guangdong

目的:探讨粤北地区缺血性脑卒中患者抗血小板药物院外用药依从性及其影响因素。方法:选取2018年1月-2019年3月粤北地区接受抗血小板药物治疗缺血性卒中患者716例。根据用药依从性评估表的内容对患者出院后10 d,1、3、6个月进行用药依从性评估,并对影响用药依从性的因素进行相关性分析。结果:在随访时间内脱落研究的患者共计44例,实际纳入患者672例,随访有效率93.9%(672/716)。随着时间的延长,患者用药依从性逐渐下降,对不同时间段缺血性脑卒中患者用药依从性进行趋势性χ^2检验发现,差异有统计学意义(χ^2=69.716,P<0.05)。单因素分析显示,用药依从性高和用药依从性差比较,在文化程度、医疗支出方式、复诊、接受医疗资源的困难程度、症状改善、高血压、糖尿病、对疾病和药物是否了解方面比较差异有统计学意义(P<0.05)。Logistic回归模型分析显示,对疾病和药物不了解、无复诊、接受医疗资源难度大、高血压、糖尿病是导致用药依从性差的独立危险因素(OR>1,P<0.05)。结论:粤北地区缺血性脑中患者院外用药依从性整体状况较差,随着用药时间延长,依从性下降,而影响用药依从性差的因素较多,应根据相关影响因素采取针对性的干预措施以及健康指导,以提高患者用药依从性。

Objective:To investigate the compliance of antiplatelet drugs with out-of-hospital medications and its influencing factors in patients with ischemic stroke in the Northern Guangdong.Method:A total of 716 patients who received antiplatelet drugs for ischemic stroke were selected from January 2018 to March 2019 in Northern Guangdong.According to the content of the medication compliance assessment form,patients were evaluated for medication compliance at 10 days,1,3,6 months after discharge,and correlation analysis was performed on factors affecting medication compliance.Result:There were 44 patients who dropped out during the follow-up period,and 672 patients were actually included.The follow-up efficiency was 93.9%(672/716).With the extension of time,the patient’s medication compliance gradually decreased,and the trend of the medication compliance of patients with ischemic stroke in different periods was analyzed by the trendχ^2 test,and the difference was statistically significant(χ^2=69.716,P<0.05).Univariate analysis showed that there was a significant difference in the level of education compliance,medical expenditures,follow-up visits,difficulty of receiving medical resources,improvement of symptoms,hypertension,diabetes,and understanding of diseases and drugs(P<0.05).Logistic regression model analysis showed that ignorance of disease and drugs,no re-examination,difficulty in receiving medical resources,hypertension,and diabetes were independent risk factors that led to poor medication compliance(OR>1,P<0.05).Conclusion:The overall status of adherence to out-of-hospital medications in patients with ischemic brain in the Northern Guangdong region is poor.With prolonged medication duration,compliance decreases,and there are many factors affecting poor medication compliance.Targeted interventions should be taken according to relevant factors measures and health guidance to improve patient medication compliance.