综合性三甲医院门诊精神疾病患者服药依从性影响因素分析

Analysis of factors influencing medication adherence among the outpatients with mental illness in a comprehensive tertiary care hospital

目的研究门诊精神疾病患者服药依从性状况及其影响因素。方法2019年1-9月采用横断面调查方法,选取重庆市某综合性三甲医院临床心理科门诊就诊患者306例,采取一般资料调查问卷和Morisky 8项用药依从性量表测量患者服药依从性,采用多元有序logistic回归模型分析其影响因素。结果306例患者中服药依从性好、服药依从性中等、服药依从性差分别占8.8%(27/306)、26.5%(81/306)、64.7%(198/306)。影响门诊患者依从性的因素包括目前精神疾病类型、疾病控制情况、服药时间、每天服药次数、对医生信任程度等(P<0.05)。结论门诊精神疾病患者服药依从性较差,在给药方式上应尽量简化容易操作、尽早控制患者症状、针对不同经济条件的患者使用可长期坚持服用的药物、鼓励患者坚持治疗的信心和决心。

Objective To study the medication adherence status of the outpatients with psychiatric disorders and its influencing factors.Methods From January to September 2019,a total of 306 patients from the outpatient clinic of the clinical psychology department in a comprehensive tertiary hospital in Chongqing were selected using the cross-sectional survey method.The general information questionnaire and Morisky 8-item medication adherence scale were used to measure the patients′medication adherence.Multivariate ordered logistic regression model was used to analyze the influencing factors.Results Among the 306 patients,8.8%(27/306),26.5%(81/306)and 64.7%(198/306)had good,moderate and poor medication adherence respectively.The factors affecting the adherence of the outpatients included type of current mental illness,disease control,time to take medication,number of doses per day,and trust in physicians(P<0.05).Conclusion The patients with mental illness in the outpatient department have poor medication adherence.Control patients′symptoms as soon as possible,use long-term drugs for the patients with different economic conditions,encourage the patients to adhere to treatment confidence and determination.