基于老年骨质疏松症的门诊处方建立患者依从性预测模型及其验证
Establishment of a Predictive Model for Patient Compliance Based on Outpatient Prescription for Osteoporosis in the Elderly and Its Validation
冯冰冰 1杨亚军2
作者信息
- 1. 广东医科大学附属医院,湛江 524001
- 2. 广东医科大学,湛江 524023
- 折叠
摘要
目的 统计老年骨质疏松症患者应用门诊处方依从性情况,基于老年骨质疏松症门诊处方的患者依从性建立预测模型并进行验证.方法 通过广东医科大学附属医院门诊处方前置审核系统,收集2023 年1 月—2023 年 12 月医院收治的 195 例老年骨质疏松资料,使用中文修订版服药依从性量表评估患者治疗依从性,将其分为治疗依从性不佳组 57 例(29.23%),依从性较好组 138 例(70.77%),将治疗依从性不佳组 57 例患者通过随机分组分为训练集(45 例)和验证集(12 例).采用单因素和多因素logistic 回归分析影响依从性因素,同时构建预测患者治疗依从性不佳的列线图模型,并进行验证.结果 年龄(>75 岁)、文化程度(小学及以下)、独居、合并基础疾病、服药种类(>4 种)、未定期在同一门诊随访是老年骨质疏松患者使用门诊处方药治疗后依从性不佳的危险因素(P<0.05).列线图模型验证结果显示训练集和验证集的一致性指数分别为 0.803(95%CI:0.758～0.826)和 0.811(95%CI:0.761～0.823),校正曲线趋近于理想曲线,AUC 分别为 0.755(95%CI:0.714～0.811)和 0.843(95%CI:0.725～0.883).结论 本研究建立的基于老年骨质疏松症门诊处方的患者依从性预测模型具有较高的准确性和可靠性,能够有效预测患者的用药依从性情况.
Abstract
Objective To analyze the compliance of outpatient prescription in elderly patients with osteoporosis,and to es-tablish and verify the prediction model based on the compliance of outpatient prescription in elderly patients with osteoporosis.Meth-ods Through the pre-review system of outpatient prescription of Affiliated Hospital of Guangdong Medical University,a total of 195 cases of elderly osteoporosis admitted to the hospital from January 2023 to December 2023 were collected.The treatment compliance of the patients was assessed using the Chinese revised medication compliance scale.They were divided into poor treatment compliance group(57 cases,29.23%)and good compliance group(138 cases,70.77%).57 patients in poor treatment compliance group were randomly divided into training set(45 cases)and verification set(12 cases).Univariate and multivariate logistic regression analysis were also used to analyze the factors affecting compliance,and a nomogram model predicting poor treatment compliance in patients was constructed and validated.Results Age(>75 years),education level(primary school and below),living alone,combined under-lying diseases,type of medication(>4),and irregular follow-up in the same clinic were risk factors for poor compliance in elderly pa-tients with osteoporosis after treatment with outpatient prescription drugs(P<0.05).The nomogram model validation results showed that the consistency indices of the training and validation sets were 0.803(95%CI:0.758-0.826)and 0.811(95%CI:0.761-0.823),respectively,and the calibration curves tended to be ideal curves,with AUC of 0.755(95%CI:0.714-0.811)and 0.843(95%CI:0.725-0.883),respectively.Conclusion The patient compliance prediction model based on outpatient prescription for osteoporosis in the elderly established in this study has high accuracy and reliability and can effectively predict the medication compli-ance of patients.
关键词
骨质疏松/门诊处方/依从性/预测模型Key words
Osteoporosis/Outpatient prescription/Compliance/Predictive model引用本文复制引用
基金项目
国家自然科学基金资助项目(82274641)
出版年
2024
国家科技期刊平台
NSTL
万方数据