MMAS-8评价COPD患者吸入DPI类药物依从性的信效度分析及应用

Reliability and validity analysis and application of MMAS-8 in evaluating the compliance of inhaled DPIs in patients with COPD

目的对8条目Morisky用药依从性量表(MMAS-8)调查COPD患者吸入DPI类药物依从性的信效度进行评价,分析不同因素对用药依从性的影响,评价药物治疗管理服务对用药依从性的影响。方法选取某院呼吸内科2019年5月至10月住院的110例COPD患者进行MMAS-8评分及信效度分析,采用有序多分类logistic回归分析各影响因素与依从性的关系,并对患者进行药物治疗管理服务,采用MMAS-8评价药物治疗管理服务前后患者的用药依从性。结果101例患者中,入组时依从性为(4.39±2.01)分。不同医疗保险、文化程度和吸入装置使用时间的依从性比较,差异有统计学意义(P<0.05)。量表总分前27%(25例)和后27%(25例)的两个极端组的平均分的Levene法F检验差异有统计学意义(P<0.05),内部一致性系数为0.657,结构效度(KMO)值为0.680,Bartlett’s球形检验值为119.900,共提取3个公共因子,解释总方差的60.203%。依从性影响因素为医疗保险类型、文化程度、吸入装置使用时间。患者经过药物治疗管理服务,出院12个月后的依从性为(6.25±1.06)分。药物治疗管理服务前后依从性总分、无意类及有意类得分比较,差异有统计学意义(P<0.05)。结论MMAS-8量表信效度良好,药物治疗管理服务有助于提高患者吸入DPI类药物依从性。

Objective To evaluate the reliability and validity of the Morisky medication adherence scale(MMAS-8)in investigating the compliance of inhaled DPIs in COPD patients,to analyze the influence of different factors on medication compliance,and to evaluate the effect of medication management services on medication compliance.Methods A total of 110 patients with COPD who were hospitalized in the Department of Respiratory Medicine in a hospital from May to October 2019 were selected for MMAS-8 score and reliability and validity analysis.Drug treatment management services were provided to patients,and MMAS-8 was used to evaluate patients’medication compliance before and after drug treatment management services.Results Among the 101 patients,the compliance at the time of enrollment was(4.39±2.01)points.There were statistically significant differences in the compliance of different medical insurance,educational level,and inhalation device usage time(P<0.05).There was a significant difference in the mean scores of the two extreme groups in the top 27%(25 patients)and the bottom 27%(25 patients)of the total scale score(P<0.05),and the internal consistency coefficient was 0.657.The validity(KMO)value was 0.680,and the Bartlett’s sphericity test value was 119.900.Three common factors were extracted,explaining 60.203%of the total variance.Adherence factors were medical insurance type,educational level,and inhalation device usage time.The patients’compliance after a year was(6.25±1.06)points after the medication management service.There were statistically significant differences in the total compliance scores,unintentional,and intentional scores before and after medication therapy management service(P<0.05).Conclusion The MMAS-8 scale has good reliability and validity,and medication management services can help improve the compliance of patients with inhaled DPIs.