炎症性肠病患儿服药依从性现状及风险因素研究  

Prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease

作　　者：吴园园[1] 罗优优[2] 黄凌斐[1] 王慧娟[1] 高向波[1] 孙琎[1] 陈洁[2] Wu Yuanyuan;Luo Youyou;Huang Lingfei;Wang Huijuan;Gao Xiangbo;Sun Jin;Chen Jie(Department of Pharmacy,Children′s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China;Department of Gastroenterology,Children′s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310051,China)

机构地区：[1]浙江大学医学院附属儿童医院药剂科,国家儿童健康与疾病临床医学研究中心,杭州310051 [2]浙江大学医学院附属儿童医院消化内科,国家儿童健康与疾病临床医学研究中心,杭州310051

出　　处：《中华儿科杂志》2022年第11期1191-1195,共5页Chinese Journal of Pediatrics

基　　金：浙江省医药卫生科技计划(2022494963);浙江省药学会医院药学专项科研资助项目(2021ZYY16)。

摘　　要：目的探讨炎症性肠病(IBD)患儿服药依从性现状及其风险因素。方法横断面研究。选择2020年9月至2021年12月在浙江大学医学院附属儿童医院就诊的112例IBD患儿为研究对象,采用问卷形式,收集患儿的一般资料、服药依从性评分资料及其父母疾病相关知识得分资料,根据服药依从性评分结果分为依从性良好组(评分6~8分)和依从性不良组(评分<6分),比较两组患儿的人口统计学与临床特征,并采用多因素二元Logistic回归分析,探讨影响患儿服药依从性的风险因素。结果112例IBD患儿中男76例、女36例,年龄12.9(9.5,14.0)岁。服药依从性不良组与依从性良好组的患儿分别为50例(44.6%)和62例(55.4%)。患儿服药频率及其父母的克罗恩病与溃疡性结肠炎知识问卷得分均与患儿服药依从性不良有关(均P<0.05);多因素二元Logistic回归分析显示,与0~6岁患儿相比,7~12岁患儿(OR=9.30,95%CI 1.58~54.87,P=0.014)与13~18岁患儿(OR=8.26,95%CI 1.49~45.85,P=0.016)服药依从性不良风险较高;与每日服药次数≤1次患儿相比,每日服药次数≥2次患儿(OR=12.88,95%CI 2.77~59.80,P=0.001)的依从性风险更高;患儿父母的克罗恩病与溃疡性结肠炎知识问卷得分(OR=0.76,95%CI 0.66~0.89,P<0.001)也是其显著影响因素。结论IBD患儿服药依从性不良现象较为普遍。患儿年龄较大(≥7岁)、每日服药频率较高(≥2次)及其家长疾病相关知识掌握不佳是患儿服药依从性不良的独立风险因素,临床应重点关注、及时干预以促进其服药依从性,改善临床结局。Objective To investigate the prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease(IBD).Methods A cross-sectional study was conducted in Children′s Hospital,Zhejiang University School of Medicine from September 2020 to March 2022 and 112 children with IBD were enrolled.Their general information,medication adherence,and parental disease-related knowledge were collected by questionnaires.According to the medication adherence score,the children were divided into the adherence group(score of 6 to 8)and the non-adherence group(score of<6),then the demographic and clinical characteristics of the two groups were compared.Subsequently,a multivariate binary Logistic regression analysis was performed to determine the risk factors of medication non-adherence.Results Of the 112 children,76 were males and 36 females,with the age of 12.9(9.5,14.0)years.There were 50(44.6%)in the non-adherence group and 62(55.4%)in the adherence group.Regarding the demographic and clinical characteristics,the results showed that the dosage frequency and the parental disease related knowledge were associated with medication non-adherence(both P<0.05).Multivariate binary Logistic regression analysis showed that compared with 0-6 years old children,the risk of medication non-adherence was significantly increased in children aged 7-12 years(OR=9.30,95%CI 1.58-54.87,P=0.014)and 13-18 years(OR=8.26,95%CI 1.49-45.85,P=0.016);and the risk was also significantly increased in children who took medication twice or more per day(OR=12.88,95%CI 2.77-59.80,P=0.001)compared with children who took medication once per day.Meanwhile,the parental score of the questionnaire on Crohn′s disease and ulcerative colitis related knowledge(OR=0.76,95%CI 0.66-0.89,P=0.001)was also a significant risk factor.Conclusions Medication non-adherence is common in children with IBD.Children older than 7 years,a dosage frequency of twice or more per day,and parental poor disease-related knowledge are the independent risk factors for

关 键 词：炎性肠疾病 儿童 问卷调查 

分 类 号：R725.7[医药卫生—儿科]