癫痫伴发精神障碍患者服药依从性及其影响因素分析

Analysis of medication compliance and its influencing factors of patients with epilepsy and mental disorder

目的分析癫痫(EP)伴发精神障碍患者服药依从性的情况及其影响因素。方法选取上饶市第三人民医院于2019年1月至2022年1月收治的60例EP伴发精神障碍患者作为研究对象,采用Morisky用药依从性量表(MMAS-8)对患者服药依从性进行评价,按照依从性分为A组(依从性好,n=38)、B组(依从性差,n=22)。统计研究对象基线资料(性别、年龄、婚姻状况、受教育程度、职业、社会支持、居住方式、居住环境、家庭收入、住院次数等)与服药依从性差的原因。采用logistic回归分析对EP伴发精神障碍患者服药依从性的相关因素进行筛选。结果两组患者的居住环境、家庭月收入、住院次数比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示:家庭月收入(β=1.021,OR=2.776,95%CI=1.262~6.104)、居住环境(β=0.964,OR=2.622,95%CI=1.172~5.868)为患者服药依从性的影响因素(P<0.05)。在B组服药依从性差的原因调查中,患者服药依从性差的原因选择率占50%以上的主要有:因各种原因忘记服用与认为服药会遭受歧视。结论EP伴精神障碍患者服药依从性差的主要原因包括忘记服药与认为服药会遭受歧视,患者服药依从性的影响因素主要包括家庭收入和居住环境。

Objective To analyze the factors related to medication compliance of patients with epilepsy(EP)and mental disorder.Methods Sixty patients with EP and mental disorder who were admitted to the Third People′s Hospital of Shangrao City from January 2019 to January 2022 were selected as the research subjects.The Morisky medication adherence scale(MMAS-8)was used to evaluate the patients′medication compliance,and they were were divided into group A(good compliance,n=38)and group B(poor compliance,n=22)according to compliance.The baseline data(gender,age,marital status,education level,occupation,social support,living pattern,living environment,family income,hospitalization times,etc.)were analyzed to investigate the reasons for poor medication compliance.Logistic regression analysis was conducted to screen the factors related to medication compliance of patients with EP and mental disorder.Results There were statistically significant differences between the two groups in living environment,monthly household income and hospitalization times(P<0.05).Logistic regression analysis showed that monthly family income(β=1.021,OR=2.776,95%CI=1.262-6.104)and living environment(β=0.964,OR=2.622,95%CI=1.172-5.868)were influencing factors of patients′medication compliance(P<0.05).Among the causes of poor medication compliance,the proportions of forgetting to take medicine for various reasons and thinking that taking medicine would be discriminated against were higher than 50%.Conclusion The main reasons for poor medication compliance of patients with EP and mental disorder include forgetting to take medication and thinking that taking medication will be discriminated against.The main influencing factors of patients′medication compliance include family income and living environment.