中国“三高”慢性病患者药物治疗依从性差异与分布情况

Differences and distribution of medication adherence among patients with chronic diseases in China

目的回顾性分析我国高血压、糖尿病、高脂血症“三高”慢性病患者药物治疗依从性研究文献,了解慢性病患者药物治疗依从性研究现状及地理差异,为后续研究提供参考。方法检索PubMed、中国知网、万方和维普等国内外数据库,以“三高”患者为研究对象,筛选与药物治疗依从性研究相关的文献,分析不同地区药物治疗依从性的现状及差异,并应用Excel软件分析依从性分布情况。结果最终纳入相关文献277篇。我国“三高”患者药物治疗依从性研究地区分布不均衡,北京(33篇)、广东(27篇)、上海(25篇)等发达地区相关研究较多,其次是以江苏(22篇)和浙江(20篇)为代表的沿海地区,而西北和东北地区相关研究很少(<5篇)。依从性判定方法多种多样,以MMAS量表应用最多,依从性在37.80%~95.50%。病种研究也有较大差异,高血压、糖尿病和高脂血症依从性研究数量占比分别为70.40%、25.99%、1.44%。医师、护理人员、药师作为依从性干预者的比例分别为25.41%、30.33%、21.31%。结论我国“三高”患者药物治疗依从性存在明显的地理差异,越发达的地区,依从性研究越多,但仍缺乏全国范围的大样本研究,药师作为依从性干预者仍有较大的提升空间。

Objective To reveal the research status and geographical differences by retrospectively analyzing literatures on medication adherence among patients with chronic diseases in China,and to provide reference for adherence studies.Methods Domestic and foreign databases of PubMed,CNKI,Wanfang,and VIP were retrieved.Patients with hypertension,diabetes and hyperlipidemia were selected as the research subjects,and literatures on medication adherence were screened.The current status of and differences in medication adherence in different regions were compared and analyzed,and the distribution of medication adherence was analyzed by Microsoft Excel.Results Totally 277 literatures were included.Regional distribution imbalance was found in the medication adherence studies in China,with more studies conducted in Beijing(33 articles),Guangdong(27 articles),Shanghai(25 articles)and other developed areas,followed by coastal areas represented by Jiangsu(22 articles)and Zhejiang(20 articles),while very limited studies in northwest and northeast China(<5 articles).There were various adherence assessments,and MMAS scale was the most widely used,with medication adherence ranging from 37.80%to 95.50%.There was also a great difference in the number of medication adherence studies,with hypertension,diabetes and hyperlipidemia accounting for 70.40%,25.99%and 1.44%,respectively.Physicians,nurses and pharmacists as adherence interveners occupied 25.41%,30.33%and 21.31%,respectively.Conclusion There are significant geographical differences in medication adherence of patients with chronic disease in China.The more developed the region,the more studies on adherence.Nationwide large sample studies are not found.Pharmacists as adherence interveners can do better jobs improvement.