山西省全科医生对老年人潜在不适当用药问题知信行情况的调查及相关因素分析

Status quo of knowledge,attitudes and practice of general practitioners on potentially inappropriate medication in the elderly in Shanxi Province and relevant factors

目的调查山西省全科医生对老年人潜在不适当用药(PIM)问题的知信行情况并探讨其相关因素。方法本研究为横断面调查。于2021年1月1日至2月20日,结合文献评阅和专家咨询,制定全科医生老年人PIM的知信行调查问卷,内容包括全科医生的基本情况及老年人PIM知信行情况。采用便利抽样方法,分别抽取山西省全科联盟单位中的一、二、三级医院各16所,以所选医院全科医学科中注册的257名在岗全科医生作为研究对象,现场发放问卷二维码调查,收集资料,分析全科医生老年人PIM防治的认知、态度和行为得分,并采用单因素分析及多重线性回归分析其相关因素。结果共发放问卷257份,回收有效问卷248份,有效率96.5%。248名全科医生老年人PIM知识、信念和行为得分分别为(31.4±9.2)、(32.9±4.6)和(34.9±8.3)分,得分率分别为62.8%(31.4/50.0)、82.3%(32.9/40.0)和69.8%(34.9/50.0);总得分为(99.2±16.3)分,总得分率为70.9%(99.2/140.0)。不同学历、工作单位、技术职称、是否知晓PIM及对PIM培训知识需求不同的全科医生老年人PIM知信行总得分差异有统计学意义(F=6.14、4.39、5.38,t=2.97、2.62,均P<0.05)。具有本科及研究生学历、高级技术职称的全科医生PIM知信行更好(t=2.69、2.98、2.36,均P<0.05),不知晓PIM及对PIM培训无需求的全科医生PIM知信行更差(t=-2.96、-2.09,均P<0.05)。结论全科医生对老年人PIM知识、态度及行为干预能力有待提高。可加强对低学历、低技术职称、不知晓PIM及认为自身对PIM培训无需求的全科医生老年人PIM知识及技能培训。

Objective To investigate the levels of knowledge,attitudes and practice of general practitioners on potentially inappropriate medication(PIM)in the elders in Shanxi Province and to explore its relevant factors.Methods A cross-sectional survey on knowledge,attitudes and practice of general practitioners on PIM in the elders was conducted from January to February 2021.A self-designed questionnaire was used for the survey,which included the basic information of general practitioners and the knowledge,attitudes and practice of elderly PIM.The convenient sampling method was used to select 16 primary,secondary and tertiary hospitals from the general practice alliance units in Shanxi Province,and 257 general practitioners in the selected hospital were recruited as the research objects.The related factors were investigated by univariate regression and multiple stepwise linear regression analyses.Results A total of 257 questionnaires were distributed,and 248 valid questionnaires were recovered,with an effective rate of 96.5%.The scores of elderly PIM knowledge,attitudes and behavior of 248 general practitioners were(31.4±9.2),(32.9±4.6)and(34.9±8.3),respectively,with the scoring rates of 62.8%(31.4/50.0),82.3%(32.9/40.0)and 69.8%(34.9/50.0).The total score was(99.2±16.3),and the total score rate was 70.9%(99.2/140.0).There was a statistically significant difference in the total score of elderly PIM knowledge,attitudes and practice among general practitioners with different educational background,work units,professional title,awareness level of PIM and needs for PIM training(F=6.14,4.39 and 5.38,t=2.97 and 2.62,all P<0.05).Multivariate analysis showed that general practitioners with undergraduate and graduate education and higher professional titles had better knowledge,attitudes and practice of PIM(t=2.69,2.98 and 2.36,all P<0.05),and general practitioners without knowledge of PIM and no needs for PIM training had worse knowledge,attitudes and practice of PIM(t=-2.96 and-2.09,all P<0.05).Conclusions The knowledge,attitudes and behavior intervention of general practitioners on elderly PIM needs to be improved.It is necessary to strengthen the elderly PIM knowledge and skill training for general practitioners with low educational background,lower professional titles without awareness and training of PIM.