北京市社区严重精神障碍患者长效针剂选择意愿研究

A study on willingness to choose long-acting injections for patients with severe mental disorders in Beijing community

目的了解北京市长效针剂使用现况,分析北京市社区严重精神障碍患者对长效针剂选择意愿及相关影响因素。方法采用分层整群抽样,从全市16个区中抽取15个街/乡,采用李克特5点评分法对患者的参与长效针剂的意愿进行评分。结果调查对象中,79.66%以前从未听说过长效针剂;在本次调查前知晓长效针剂的患者中,72.05%由专科医生告知信息;70.05%的调查对象不愿意或非常不愿意选择长效针剂;使用免费提供长效针剂选择意愿评分高于医保后自费(P<0.01);医保后自付针剂费用不同疾病类型患者选择意愿比较差异有统计学意义(P<0.05)。免费提供长效针剂不同城市功能分区、户籍、有无共同居住者、受教育程度、疾病类型、职业状态的患者选择意愿比较差异均有统计学意义(P<0.05)。结论长效针剂治疗在社区患者中知晓率、治疗意愿均较低,而药品费用高是患者拒绝尝试长效针剂的最主要原因之一,应进一步加强对长效针剂使用的宣教,采取相关措施改善患者对长效治疗的态度。

Objective To understand the current situation of long-acting injections(LAIs)use in Beijing,and to analyze the willingness of patients with severe mental disorders in Beijing community to choose LAIs and its related influencing factors.Methods Stratified cluster sampling was used to choose 15 streets/townships from 16 districts of Beijing city,and Likert scale was used to score the willingness of patients choosing LAIs.Results 79.66%of the respondents had never heard of LAIs before.Among the patients who knew LAIs before this survey,72.05%were informed by specialist doctors;70.05%of the respondents were unwilling or very unwilling to choose LAIs.Free LAIs could improve the level of willingness to choose LAIs compared with self-pay after medical insurance(P<0.01).For self-pay after medical insurance,there existed significant difference in the willingness to choose LAIs among patients with different kinds of disorders(P<0.05).For providing free LAIs,there were significant differences in the willingness to choose LAIs among patients in different urban functional zones,with different household registrations,education levels,disease types,occupational statuses and whether having co-residents or not(P<0.05).Conclusion The awareness rate and treatment willingness of LAIs therapy are both low in patients in the community,and the high drug cost is one of the main reasons why patients refuse to try LAIs therapy.Therefore,the propaganda and education on the use of LAIs should be further strengthened and relevant measures should be taken to improve patients’attitudes towards LAIs therapy.