抗结核固定剂量复合制剂在定点医院推广使用的相关因素分析  

Analysis on the correlative factors of anti-tuberculosis fixed-dose compound preparation used in designated hospitals

作　　者：钟引 何金戈[1] 李京 杨妮[1] 刘莉 谢艳[3] ZHONG Yin;HE Jinge;LI Jing;YANG Ni;LIU Li;XIE Yan(Department of Tuberculosis Control and Prevention,Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Department of the Management of Major Infectious Diseases,Public Health Clinical Center of Chengdu,Chengdu 610041,Sichuan Province,China;Department of Tuberculosis Control and Prevention,Zigong Center for Disease Control and Prevention,Zigong 643000,Sichuan Province,China.)

机构地区：[1]四川省疾病预防控制中心结核病防治所,成都610041 [2]成都市公共卫生临床医疗中心重大传染病管理部,成都610066 [3]自贡市疾病预防控制中心结核病防治所,四川自贡643000

出　　处：《预防医学情报杂志》2023年第6期680-685,共6页Journal of Preventive Medicine Information

摘　　要：目的了解抗结核固定剂量复合剂(FDC)在省市级结核病定点医院使用现状及推广可行性。方法按照典型抽样的方法,在四川省分别选取省级、市级各1个结核病定点医院作为研究现场,调查2021年1至7月登记的新诊断利福平敏感或无耐药检测结果的肺结核患者FDC使用情况,并对2021年4至7月使用抗结核FDC治疗的500例患者进行随访检查,分析其纳入和退组情况,使用线性趋势卡方检验分析退组率随疗程的变化趋势,以P<0.05为差异有统计学意义。随机抽取纳入患者和医务人员分别进行服药依从性及对抗结核FDC认识、推广障碍和建议的定性访谈。结果2家结核病定点医院2021年1至3月就诊患者抗结核FDC使用率为4.62%(3/65);2021年4至7月共登记新诊断的利福平敏感或无耐药检测结果的肺结核患者598人,FDC使用率为83.11%(497/598);未使用抗结核FDC的患者中45.54%(46/109)认为方案不合适,使用抗结核FDC的患者中42.05%(209/497)在疗程中途停止使用,其中60.29%(129/209)由于发生不良反应或死亡而退组,退组率随疗程呈明显下降趋势(Z=50.755,P<0.05)。定性访谈中发现,影响抗结核FDC推广因素有患者知晓度、接受度低,医务人员对抗结核FDC认识有限。结论强化推广措施可提升省市级结核病定点医院的抗结核FDC使用率。在此过程中,关键在于加强对医务人员培训,对患者进行健康教育,提高其治疗管理依从性。Objective To know about the use status and promotion feasibility of anti-tuberculosis fixeddose combinationn(FDC)in provincia1l and municipal designated medical institutions.Methods According to the method of typical sampling,one tuberculosis designated hospital at provincial and municipal level was selected as the research site in Sichuan Province,respectively.FDC use of tuberculosis patients newly diagnosed with rifampicin sensitivity or without drug resistancetest results was investigated from January to July 2021,and 500 patients who received anti-tuberculosis FDC treatment from April to July 2021 were followed up.The situation of inclusion and withdrawal were analyzed,and the trend of withdrawal rate with treatment course was analyzed by linear trend Chi-square test.P<0.05 was considered statistically significant.Patients and medical staff were randomly selected for qualitative interviews on medication compliance,awareness of FDC against TB,barriers to promotion and recommendations.Results The utilization rate of anti-tuberculosis FDC among patients admitted to two TB designated hospitals from January to March 2021 was 4.62%(3/65);A total of 598 newly diagnosed tuberculosis patients with rifampicin sensitivity or no drug resistance test results were registered from April to July 2021,and the utilization rate of FDC was 83.11%(497/598).45.54%(46/109)of the patients who did not use anti-tuberculosis FDC were classified as inappropriate.Among the patients who used anti-tuberculosis FDC,42.05%(209/497)of them stopped using anti-tuberculosis FDC during the course of treatment,and 60.29%(129/209)of them withdrew from the group due to adverse reactions or death,and the withdrawal rate showed a significant downward trend with the course of treatment(Z=50.755,P<0.05).In qualitative interviews,it was found that the factors affecting the promotion of anti-tuberculosis FDC were low awareness and acceptance of patients,and the limited awareness of anti-tuberculosis FDC among medical staff.Conclusions Intensive promotion

关 键 词：结核 固定剂量复合剂 推广应用 

分 类 号：R52[医药卫生—内科学]