慢性阻塞性肺疾病患者吸入制剂依从性调查  

Investigation on adherence to inhaled medication among patients with chronic obstructive pulmonary disease

作　　者：林佳媛[1] 何乐[1] 徐斌[2] 程齐俭[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院北院药剂科,上海201801 [2]上海市交通大学医学院附属瑞金医院药剂科,上海200025 [3]上海交通大学医学院附属瑞金医院北院呼吸内科,上海201801

出　　处：《临床肺科杂志》2017年第4期658-661,共4页Journal of Clinical Pulmonary Medicine

基　　金：上海申康医院发展中心慢性病综合防治项目(NoSHDC12012305)

摘　　要：目的调查慢性阻塞性肺疾病(慢阻肺)患者出院后使用吸入制剂的依从性情况及影响因素。方法通过查询患者吸入剂处方信息结合电话随访问卷,对本院呼吸内科2013年1月-2015年6月收治的出院诊断为慢阻肺且医嘱长期使用吸入制剂的患者进行调查。结果共收治了49例慢阻肺患者,纳入本研究的患者39例,其中46.2%(n=18)依从性好,53.8%(n=21例)依从性差。病程长短和急性发作次数(次/年)是影响吸入制剂依从性的相关因素。病程长(>10年),急性加重次数多(≥2次/年)的患者依从性差(P<0.05)。患者依从性差的原因包括:缺乏对慢阻肺的认识,未及时复诊,遗忘配药,配药不便,觉得吸入制剂没效果,认为吸入制剂费用昂贵。结论尽管患者在住院期间均进行过用药宣教,但结果提示收效并不理想。临床医生和药师应该采用积极的干预措施,提高患者长期规范用药依从性。Objective To investigate the factors associated with adherence to inhaled medications among dis- charged patients with COPD. Methods Those patients with COPD discharged from respiratory ward and prescribed long-acting inhaled medications from January 2013 to June 2015 were investigated by prescription information and tel- ephone questionnaire. Results 39 patients included in the study from 49 hospitalized patients with COPD, 46.2% （ n = 18） were with higher adherence while 53.8% （n = 21 ） were with lower adherence. The factors associated with adherence were course of disease and frequency of exacerbations. Longer course of disease （ 〉 10 years） and higher frequency of exacerbations （ t〉2 per year） were associated with lower adherence （ P 〈 0.05 ）. Lower adherence was associated with lack of knowledge of COPD, delayed return visit, forgetting prescription, unavailable for prescription, considering inhaled medications ineffective or expensive. Conclusion Although all inpatients were repeatedly edu- cated, the results showed unsatisfactory. Physicians and pharmacists should intervene to improve adherence to inhaled medications.

关 键 词：慢性阻塞性肺疾病 吸入剂 依从性 

分 类 号：R563.9[医药卫生—呼吸系统]