江苏省肺结核患者电子药盒的取药记录与实际服药的一致性研究  

Consistency study on treatment adherence among TB patients using medication monitors in Jiangsu

作　　者：彭红[1] 陆伟[1] 竺丽梅[1] 印伟[2] 顾欣荣[3] 薛浩[2] 陆峰[3] 朱立国[1] 

机构地区：[1]江苏省疾病预防控制中心,南京210009 [2]江苏省盐城市疾病预防控制中心,盐城224002 [3]江苏省南通市疾病预防控制中心,南通226007

出　　处：《江苏预防医学》2013年第1期13-16,共4页Jiangsu Journal of Preventive Medicine

基　　金：中国卫生部-盖茨基金会结核病防治合作项目(51914)

摘　　要：目的通过肺结核患者尿液中抗结核药物残留物检测,验证电子药盒的取药记录与患者实际服药的一致性。方法在应用电子药盒开展肺结核患者管理试点地区,随机连续纳入新登记的初治结核患者138例作为研究对象,其中强化期患者74例,继续期患者64例。所有纳入患者均采用隔日化疗方案2H3R3Z3E3/4H3R3,并使用电子药盒进行治疗管理。在不提前通知患者情况下,医务人员上门收集患者尿液,并用三氯甲烷检测尿液中利福平类药物残留,确定患者的服药状况。通过对比患者同一天的电子药盒记录和尿液中结核病药物残留物检测结果,观察两种方法结果的异同。结果在纳入的138例患者中,对108例患者尿液进行了检测,检测率为78.26%(108/138)。患者24h内电子药盒的取药记录反映患者实际服药行为的灵敏度和特异度均为100.0%(108/108)。同时,电子药盒在不同性别组患者的灵敏度和特异度以及处于不同治疗阶段患者的灵敏度和特异度均较高;统计学分析显示患者电子药盒取药记录和尿液中抗结核药物残留物检测结果在不同人群中的应用差异均无统计学意义(P>0.05)。结论电子药盒的取药记录与肺结核患者服药行为高度一致,可以作为协助监测肺结核患者服药行为的新工具加以推广应用。Objective With urine testing for TB drug traces, to verify adherence to anti--TB treatment among TB patients using medication monitors. Methods There were total 138 newly registered initial TB patients enrolled in succession in 3 coun ties of China MOH--Gates Foundation TB Control Project case management pilot sites in Jiangsu Province. Of all the patients, 74 were in the intensive phase of treatment and 64 in the continuous phase, All the patients were treated with the regimen 2H3R3Z3E3/4Ha R3 and electronic medication monitor for management and surveillance. Without prior notice, doctors visited the patients＂ house to collect urine and conduct a test with chloroform to detect Rifampicin to confirm whether patients had taken their medicine within the past 24 hours. Through comparing the medication monitors＂ records and urine testing results,the consistency can be verified. Results Among all the patients, 108 of whom were tested, accounting for 78.26~ ; 58 cases were in the intensive phase of treatment and 50 in the continuous phase. By comparison of the detection of Rifampicin in urine, the sensitivity and specificity of 24h medication monitor records as the evidence of TB drug adherence were respectively 100G. Meanwhile the sensitivity and specificity between gender groups and between treatment phases were shown no significant statistical differences （P〉0.05）. Conclusion There is a high correlation between medication monitors＂ records and the TB treatment adherence, and therefore medication monitors can be used as new case management tools to achieve better treatment outcomes.

关 键 词：肺结核 患者管理 电子药盒 一致性 

分 类 号：R521[医药卫生—内科学]