初治肺结核患者居家服药依从性及其影响因素调查

Compliance and influencing factors of home medication in patients with newly diagnosed pulmonary tuberculosis

目的了解初治肺结核患者出院后居家服药依从性的影响因素,为制定个性化的管理措施提供指导。方法以便利抽样法选取太原市第四人民医院复查的初治肺结核患者120例,采用Morisky问卷进行居家服药依从性调查,并对依从性影响因素进行多因素Logistic回归分析。结果 120例患者中,95例(79.2%)患者抗结核药物服用依从性好,25例(20.8%)患者依从性差。单因素分析显示年龄、医疗付费方式、文化程度、家庭人均月收入和服药种类是影响服药依从性的主要因素,差异均有统计学意义(P<0.05);Logistic回归分析显示,文化程度(OR=0.463)、家庭人均月收入(OR=1.771)和服药种类(OR=1.980)与服药依从性有关(P<0.05),文化程度和家庭月收入高者的服药依从性高于文化程度和家庭月收入低者,服用2类药物患者的服药依从性高于服用3类药患者;不同年龄及医疗付费方式患者服药依从性差异有统计学意义(P<0.05)。结论初治肺结核患者出院后居家服药依从性受多种因素影响,应通过个性化的解决措施,减少服药治疗中的不规范行为,提高初治肺结核治疗效果,降低耐多药结核发生。

Objective To understand the influencing factors of compliance of newly diagnosed pulmonary tuberculosis patients after home discharge,provide guidance for the development of individualized management measures.Methods One hundred and twenty newly diagnosed pulmonary tuberculosis cases were selected by convenience sampling method,compliance of home taking medicine was investigated by Morisky questionnaire,multivariate logistic regression analysis was conducted to determine the influencing factors of compliance.Results Of the 120 patients,95 patients(79.2%)had good compliance with antituberculous drugs,poor compliance in 25 cases(20.8%).Univariate analysis showed that age,mode of medical payment,educational level,per capita monthly income of the family and types of medication were the main factors influencing compliance.The differences were statistically significant(P<0.05).Logistic regression analysis showed that education level(OR=0.463),per capita monthly inncome of family(OR=1.771)and types of medication(OR=1.980)were protective factors(P<0.05).Patients with high education level and family monthly income had higher medication compliance than those with low education level and family monthly icome.The compliance of patients taking type 2 drugs was higher than that of patients taking type 3 drugs,but there were significant differences in age and mode of medical payment(P<0.05).Conclusion The compliance of patients with newly diagnosed pulmonary tuberculosis after home discharge is influenced by many factors.It is necessary to reduce the unstandardized behavior in the treatment of drug treatment by individualized measures,improve the treatment effect of the initial treatment of tuberculosis and reduce the occurrence of multi drug resistant tuberculosis.