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慢性乙型肝炎患者服药依从性的影响因素分析

Study on meication compliance and influencing factors of patients with chronic hepatitis B

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目的 了解慢性乙型肝炎(CHB)患者服用药核苷(酸)类似药(NAs)的依从性,并分析其影响因素,为提高CHB患者服药依从性提供参考.方法 采用便利抽样,选取感染科就诊且接受NAs药物抗乙肝病毒治疗的CHB患者为研究对象,采用一般资料调查表收集患者人口社会学信息与病历资料,采用 Morisky 药物依从性量表(MMAS-8)、医学应对方式问卷、社会支持评定量表评价调查对象的服药依从性、医学应对方式和社会支持水平.采用多因素Logistic回归模型,分析影响CHB患者服药依从性的相关因素.结果 201 例CHB患者服药依从性良好143 例(71.14%),依从性差 58 例(28.86%).多因素Logistic回归分析显示:文化程度高(OR=2.382)、家庭人均月收入>5 000 元(OR=2.833)、居住城市(OR=1.421)、接受过CHB相关健康教育(OR=3.507)、应对方式(面对:OR=3.096;回避:OR=1.151)、社会支持水平(高:OR=3.018;中等:OR=1.460),是CHB患者服药依从性的促进因素;多重用药(OR=0.359)是CHB患者服药依从性的制约因素.结论 CHB患者服药依从性有待提高,可能受文化程度、居住地、家庭经济状况、CHB健康教育、多重用药、应对方式和社会支持水平因素的影响.
Objective To understand the medication compliance of patients with chronic hepatitis B(CHB)who are prescribed nucleos(t)ide analogues(NAs)and analyze the factors that influence adherence.Methods A convenience sampling method was employed to select patients with chronic hepatitis B(CHB)who were receiving nucleos(t)ide analogues(NAs)treatment in the infectious disease department as the study population.A general information questionnaire was used to collect demographic and clinical data of the patients.The medication compliance of the participants,their medical coping strategies,and the level of social support were evaluated using the Morisky medication adherence scale(MMAS-8),the medical coping modes questionnaire,and the social support rating scale(SSRS)respectively.A multivariate Logistic regression model was utilized to analyze the factors influencing medication compliance in CHB patients.Results Among the 201 CHB patients included in the study,143(71.14%)demonstrated good medication compliance,while58(28.86%)exhibited poor adherence.The results of the multivariate Logistic regression analysis revealed several factors that influenced medication adherence in CHB patients.Patients with a higher level of education(OR=2.382),a monthly per capita family income greater than 5 000 yuan(OR=2.833),residing in urban areas(OR = 1.421),receiving CHB-related health education(OR = 3.507),adopting certain coping strategies(confrontation:OR=3.096;avoidance:OR=1.151),and having a higher level of social support(high:OR=3.018;moderate:OR = 1.460)were more likely to adhere to their compliance regimen.Conversely,the use of multiple medications(OR = 0.359)acted as a restrictive factor for medication compliance in CHB patients.Conclusions The medication compliance of CHB patients needs to be improved,as it may be influenced by factors such as educational level,place of residence,family economic status,CHB health education,polypharmacy,coping strategies,and social support level.

chronic hepatitis Bnucleos(t)ide analoguesantiviral treatmentcomplianceinfluence factor

杨晶艳、刘丽萍、陈梅春、周双红

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磐安县人民医院 感染科,浙江 磐安 322300

慢性乙型肝炎 核苷(酸)类似药 抗病毒治疗 依从性 影响因素

2024

健康研究
杭州师范大学

健康研究

影响因子:0.823
ISSN:1674-6449
年,卷(期):2024.44(2)
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