某市自报ADR居民用药素养及其影响因素研究

Study on drug use literacy of residents with self reported ADR in a city and its influencing factors

目的了解某市自报发生药品不良反应(Adverse Drug Reactions,ADR)居民用药素养现况,从公众角度探究其影响因素,降低居民ADR发生率、提高居民安全用药素养提供更有参考价值的依据与借鉴。方法自设问卷,于2022年6—8月对某市10个行政区,642个社区居民采取分层整群随机抽样与方便抽样结合的方式,进行线上问卷星、线下面对面调查共13534人,其中自报ADR的共883人(6.52%)。通过单因素卡方检验、二元Logistic回归分析该市自报ADR居民安全用药素养情况及其影响因素。结果883例ADR居民女性(75.76%)高于男性(24.24%);年龄以30~39岁(23.78%)及60岁以上人群(22.65%)为主;单因素卡方检验中显示不同年龄、文化程度、家庭月收入、用药知识来源的ADR居民在用药认知素养方面,差异有统计学意义(P<0.05),不同年龄、慢性病罹患情况、用药知识来源的ADR居民在用药行为素养方面,差异有统计学意义(P<0.05);二元Logistic回归分析显示30~39岁(OR=0.588,95%CI=0.373~0.928)、大专文化程度(OR=0.361,95%CI=0.140~0.927)居民不良认知发生可能较低;60岁以上居民(OR=1.856,95%CI=1.177~2.927)存在不良认知现象较显著;40~49岁(OR=0.477,95%CI=0.282~0.806)、50~59岁(OR=0.430,95%CI=0.248~0.745)、60岁以上(OR=0.357,95%CI=0.210~0.607)、用药知识多渠道(OR=0.542,95%CI=0.324~0.906)的居民发生用药不良行为现象较低;罹患1种慢性疾病(OR=1.462,95%CI=1.026~2.082)、同时患两种慢性疾病(OR=2.215,95%CI=1.337~3.670)、患三种慢性疾病(OR=3.749,95%CI=1.395~10.076)的居民更可能发生不良用药行为。结论该市居民对安全用药有一定认知但安全意识淡薄,不良用药行为时有发生,安全用药素养水平丞需提高,对该市居民开展科学有效的安全用药健康干预刻不容缓。

Objective To understand the current situation of medication literacy among residents in a city who reported the occurrence of adverse drug reactions(ADRs)themself,and to explore the influencing factors from the public point of view,in order to reduce the incidence of ADRs among residents and to provide a more informative and valuable basis and reference for improving the safe medication literacy among residents.Methods From June 2022 to August 2022,self-developed questionnaire was used to carried out online(questionnaires star)and offline face-to-face survey.The survey was conducted among 10 administrative districts of the city,including 642 community,a stratified whole cluster random sampling method and convenience sampling method were combined,finally a total of 13,534 residents were enrolled in the study,a total of 883 people(6.52%)reported ADR.The situation of safety medication literacy and influencing factors of residents reported ADR in the city were analyzed by using univariate chi square test and binary logistic regression analysis.Results Among the 883 cases reported ADR,the proportion of females(75.76%)as higher than the males(24.24%),and the age groups of 30-39 years old(23.78%)and 60 years old above(22.65%)were predominant.One-way chi-square test showed that the residents of different ages,education levels,monthly household incomes,and sources of knowledge about medication perform differences in medication cognitive literacy(P<0.05).The medication behavioral literacy was statistically significant among residents with different ages,chronic disease conditions,and sources of knowledge about medication(P<0.05).Binary logistic regression analysis showed that residents aged 30~39 years(OR=0.588,95%CI=0.373~0.928),own a Junior college degree(OR=0.361,95%CI=0.140~0.927)were unlikely to perform adverse cognitive literacy.However,the phenomenon of adverse cognitive literacy were common among residents over 60 years old(OR=1.856,95%CI=1.177~2.927).The phenomenon of adverse medication behavioral literacy were unlikely to occur among residents aged 40~49 years(OR=0.477,95%CI=0.282-0.806),50-59 years(OR=0.430,95%CI=0.248~0.745),over 60 years old(OR=0.357,95%CI=0.210~0.607),and residents with multiple sources of medication knowledge(OR=0.542,95%CI=0.324~0.906).Residents suffered from 1 chronic disease(OR=1.462,95%CI=1.026~2.082),two chronic diseases(OR=2.215,95%CI=1.337~3.670),and three chronic diseases(OR=3.749,95%CI=1.395~10.076)were more likely to have adverse medication behaviour.Conclusions Residents of the city have a certain degree of knowledge about the safe use of medication,but safety awareness is weak;adverse drug use behaviour occurs from time to time,the level of safe use of medication literacy needs to be improved,and it is urgent to carry out scientific and effective safe use of medication and health interventions for the residents of the city.