上海市松江区≥40岁社区居民COPD患病情况及抗生素认知水平对其自我使用抗生素影响

Influence of COPD and antibiotics-related knowledge on self-medication with antibiotics among community residents aged 40 and over in Songjiang district,Shanghai

目的了解上海市松江区中老年社区居民慢性阻塞性肺疾病(COPD)患病情况及抗生素认知水平对其自我使用抗生素的影响,为加强COPD患者的抗生素治疗管理提供参考依据。方法于2021年6—12月采用随机抽样方法从上海市松江区新桥、中山、佘山和泖港4个社区建立的自然人群队列中随机抽取3500名≥40岁社区居民进行问卷调查、体格检查和肺功能检查,应用多因素非条件logistic回归模型分析COPD患病情况及抗生素认知水平对自我使用抗生素的影响。结果上海市松江区最终纳入的3184名社区居民中,患COPD者259例(8.1%);抗生素认知水平得分为0、1、2和3~4分者分别为969人(30.4%)、461人(14.5%)、1462人(45.9%)和292人(9.2%);自我使用抗生素者537人,抗生素自我使用比例为16.9%;在调整了性别、文化程度、婚姻状况、居住地、吸烟情况、是否运动、有无睡眠问题、有无消化系统疾病、有无呼吸系统疾病、有无咳嗽咳痰症状、有无气促症状和BMI等混杂因素后,多因素非条件logistic回归分析结果显示,上海市松江区<60岁患COPD社区居民自我使用抗生素的可能性为未患COPD社区居民的3.31倍(OR=3.31,95%CI=1.11~9.90),≥60岁患COPD与非患COPD者社区居民自我使用抗生素情况差异无统计学意义(P>0.05);在进一步调整年龄因素后,上海市松江区抗生素认知水平得分1、2和3~4分社区居民自我使用抗生素的可能性为抗生素认知水平得分0分社区居民的0.26倍(OR=0.26,95%CI=0.18~0.36)、0.17倍(OR=0.17,95%CI=0.13~0.22)和0.17倍(OR=0.17,95%CI=0.10~0.26)。结论上海市松江区≥40岁社区居民抗生素自我使用比例较高,COPD患病情况和对抗生素认知水平较低会增加抗生素的自我使用现象。

Objective To explore the prevalence of chronic obstructive pulmonary disease(COPD),knowledge about antibiotics and their influences on self-medication with antibiotics(SMA)among middle-aged and elderly adults in communities of Songjiang district,Shanghai city.Methods The participants of the survey were 3500 residents aged 40 years and over recruited using random sampling at four communities in Songjiang district of Shanghai city.Face-to-face interview with a self-designed questionnaire and Pittsburgh Sleep Quality Index(PSQI),physical examination and spirometry test were conducted among the participants during June-December 2021.Unconditional multivariate logistic regression model was adopted to analyze the influences of COPD,knowledge and awareness about antibiotics on SMA.Results Of the 3184 participants ultimately included in the analysis,259(8.1%)were identified as having COPD.The number(proportion)of the participants with the antibiotic awareness score of 0,1,2,and 3-4(indicating complete awareness)were 969(30.4%),461(14.5%),1462(45.9%),and 292(9.2%),respectively.The number(proportion)of the participants reporting SMA was 537(16.9%).The results of unconditional multivariate logistic regression analysis showed that compared to the participants without COPD,the COPD sufferers aged under 60 years had a significantly increased risk of SMA(odds ratio[OR]=3.31,95%confidence interval[95%CI]:1.11-9.90)after adjusting for sex,education level,marital status,place of residence,smoking,exercise,sleeping status,digestive system disease,other respiratory system diseases,cough and sputum symptoms,shortness of breath symptoms,and body mass index;but the increased risk was not significant for the COPD sufferers aged≥60 years(OR=1.09,95%CI:0.74-1.60);the results also revealed that in comparison to those with the antibiotic knowledge and awareness score of 0,the participants with the knowledge and awareness scores of 1,2,and 3-4 were less likely to conduct SMA,with the ORs(95%CI)of 0.26(0.18-0.36),0.17(0.13-0.22),and 0.17(0.10 to 0.26)after adjusting for age and the confounding factors mentioned above.Conclusion The prevalence of SMA was high and the prevalence might be associated positively with suffering with COPD and reversely with the awareness about antibiotics among middle-aged and elderly community adults in Songjiang district,Shanghai.