下肢深静脉介入治疗后服药依从性影响因素分析

Influencing factors of medication compliance after interventional therapy among patients with lower-limbs deep venous thrombosis and sequelae

目的:探讨下肢深静脉血栓形成(lower-limbs deep venous thrombosis,LDVT)介入治疗后服药依从性的影响因素及后遗症发生情况。方法:选择接受介入治疗的LDVT患者92例,采用Morisky服药依从性量表(morisky medication compliance scale 8,MMAS-8)评价抗凝治疗6个月依从性,并分析其影响因素,随访1年内后遗症发生情况。结果:92例LDVT患者的MMAS-8评分为(6.4±1.4)分,其中,低依从性14例(15.2%),中等依从性43例(46.7%),高依从性35例(38.0%)。单因素及Logistic多因素分析显示,年龄>65岁(OR=0.341,95%CI:0.113~0.625)、家庭收入<2 000元/月(OR=0.425,95%CI:0.203~0.768)、买药不方便(OR=0.299,95%CI:0.124~0.581)和发生出血事件(OR=0.612,95%CI:0.118~0.813)是影响LDVT患者服药依从性的危险因素(P<0.05),文化程度(OR=2.052,95%CI:1.031~5.674)、服药知识(OR=4.361,95%CI:1.479~12.835)是保护性因素(P<0.05)。患者服药依从性越低,血栓后综合征(post thrombotic syndrome,PTS)发生率越高(P<0.05)。结论:LDVT患者介入治疗后年龄、买药方便程度、经济水平、文化程度及服药认知是影响服药依从性的主要因素,且服药依从性与后遗症有关,服药依从性越低后遗症发生率越高。

Objective:To investigate the influencing factors of medication compliance after interventional therapy among patients with lower-limbs deep venous thrombosis(LDVT)and sequelae.Methods:A total of 92 LDVT patients who received interventional therapy were selected.Morisky medication compliance scale(MMAS-8)was used to evaluate the compliance of anticoagulant therapy for 6 months,and the influencing factors were analyzed.The incidence of sequelae within 1 year was followed up and statistically analyzed.Results:The MMAS-8 score of 92 LDVT patients was(6.4±1.4),of which 14 cases with low compliance(15.2%),43 cases with moderate compliance(46.7%),and 35 with high compliance(38.0%).Single factor and logistic multivariate analysis showed that age>65 years old(OR=0.341,95%CI:0.113~0.625),family income<2000 yuan/month(OR=0.425,95%CI:0.203~0.768),inconvenience in purchasing medication(OR=0.299,95%CI:0.124-0.581),and occurrence of bleeding events(OR=0.612,95%CI:0.118-0.813)were independent risk factors affecting medication compliance in LDVT patients(P<0.05),and educational level(OR=2.052,95%CI:1.031-5.674)Medication knowledge(OR=4.361,95%CI:1.479-12.835)was protective factor(P<0.05).As patient adherence to medication decreased,the incidence of post thrombotic syndrome(PTS)significantly increased(P<0.05).Conclusions:The compliance of LDVT patients with anticoagulant medication after interventional treatment needs to be further improved.Age,convenience of medication purchase,economic level,education level and medication awareness are the main factors affecting medication compliance,and medication compliance is related to sequelae.As medication adherence decreases,the incidence of sequelae may increase.