帕金森病患者服药依从性变化轨迹及预测因素的纵向研究  

A longitudinal study of medication adherence trajectories and its prediction factors in patients with Parkinson's disease

作　　者：王曙光[1] 郭枫[1] 丁时磊[1] 何彩玉[1] 汪玉玲[1] 肖勇 程璐 姚瑞萍[1] 杨士 Wang Shuguang;Guo Feng;Ding Shilei;He Caiyu;Wang Yuling;Xiao Yong;Cheng Lu;Yao Ruiping;Yang Shi(Medicine school of Chuzhou City Vocation College,Chuzhou,Anhui,239000,China;Department of pharmacy,first people’s hospital of Chuzhou,Chuzhou,Anhui,239001,China)

机构地区：[1]滁州城市职业学院医学院,安徽滁州239000 [2]滁州第一人民药学部,安徽滁州239001

出　　处：《齐齐哈尔医学院学报》2023年第6期583-588,共6页Journal of Qiqihar Medical University

基　　金：滁州城市职业学院科研项目(2022zkyb01);滁州城市职业学院教研项目(2020jyxm02);安徽省教研重点项目(2021jyxm1038);安徽省质量工程项目(2020SJJXSFK1843)。

摘　　要：目的探讨帕金森病患者服药依从性轨迹及其影响因素。方法选择2020年10月—2021年6月滁州市5个社区招募的140例原发性帕金森病患者,进行12个月随访调查。调查工具包括社会资料调查表、临床资料调查表和Morisky服药依从性量表。通过潜类别增长模型(Latent Class Growth Model,LCGM)识别患者服药依从性轨迹,利用有序多分类Logistic回归分析影响轨迹的因素。结果本研究共纳入127例患者,根据服药依从性轨迹可分为“高-稳定型”(11.8%)、“中-降低型”(28.4%)和“低-降低型”(59.8%)。单组重复测量方差分析显示,高-稳定型轨迹不同时间点服药依从得分差异无统计学意义(P>0.05),但中-降低型和低-降低型轨迹不同时间点服药依从得分差异有统计学意义(均P<0.05)。有序多分类Logistic回归显示,文化程度(P=0.022,OR=19.665,95%CI=1.536-251.817)、工作状态(P=0.004,OR=10.285,95%CI=2.082-50.814)、用药种类(P=0.022,OR=8.356,95%CI=1.356-51.498)和智力状态(P=0.017,OR=15.551,95%CI=1.628-148.497)是服药依从性轨迹的预测因素。结论帕金森病患者服药依从性可分为3种变化轨迹,文化程度、工作状态、用药种类和智力状态是影响服药依从性轨迹的主要因素。Objective To explore the medication adherence trajectories and its influencing factors among patients with Parkinson's disease.Methods A total of 140 patients with primary Parkinson's disease were recruited from five communities in Chuzhou City from October 2020 to June 2021,and they were followed-up for 12 months.The survey tools including social data questionnaire,clinical data questionnaire and Morisky medication adherence scale,respectively.The latent class growth model(LCGM)was used to identify the trajectory category of patients'medication adherence,and the factors that affecting the trajectory category were analyzed by ordered multi-classification logistic regression.Results Totally,127 patients were enrolled in the present study.Three distinct medication adherence trajectories were identified and named as“high-stable”(11.8%),“medium-decrease”(28.4%)and“low-decrease”(59.8%).The results from single unit repeated measurement analysis of variance showed that there was no significant difference in medication adherence at different time points in“high-stable”trajectory(P>0.05),however,there were significant difference in medication adherence at different time points in“medium-decrease”and“low-decrease”trajectory(all P<0.05).The results of ordered multi-classification logistic regression demonstrated that educational level(P=0.022,OR=19.665,95%CI=1.536-251.817),work status(P=0.004,OR=10.285,95%CI=2.082-50.814),drug use type(P=0.022,OR=8.356,95%CI=1.356-51.498)and intelligence status(P=0.017,OR=15.551,95%CI=1.628-148.497)were the influencing factors that affecting the medication adherence trajectory of patients with Parkinson's disease.Conclusions The medication adherence trajectory could be assigned to three categories;Educational level,work status,drug use type and intelligence status were the influencing factors that affecting the medication adherence trajectory of patients with Parkinson's disease.

关 键 词：帕金森 服药依从性 轨迹 潜类别增长模型 

分 类 号：R979.9[医药卫生—药品]