社区精神分裂症患者服药依从性影响因素的多水平logistic回归分析  

Multilevel logistic regression analysis of influencing factors of medication compliance in patients with schizophrenia in community

作　　者：郭易 徐沛蒂 文红[2] 刘元元 刘军[2] GUO Yi;XU Pei-di;WEN Hong;LIU Yuan-yuan;LIU Jun(Department of Epidemiology and Health Statistics,West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系,四川成都610041 [2]四川省精神卫生中心(绵阳市第三人民医院)精神卫生社会防治科,四川绵阳621054

出　　处：《现代预防医学》2023年第13期2383-2388,共6页Modern Preventive Medicine

基　　金：国家自然科学基金项目(81903414);四川省基层卫生事业发展研究中心项目(SWFZ18-Y-21)。

摘　　要：目的探讨社区精神分裂症患者服药依从性的影响因素。方法研究基于某省“重性精神疾病基本数据收集分析系统”中精神分裂症患者基本信息,对患者个体因素与服药依从性进行单因素分析,再以患者水平和市州水平建立两水平logistic回归模型,分析该省精神分裂症患者服药依从性的影响因素。结果共纳入精神分裂症患者192099名,其中服药依从性良好患者有61656名,依从率为32.10%。两水平logistic回归模型结果显示,年龄较大(46-<65岁组OR=0.78,95%CI:0.76-0.80;65-100岁组OR=0.57,95%CI:0.55-0.59)、男性(OR=0.85,95%CI:0.83-0.87)、少数民族(OR=0.71,95%CI:0.63-0.79)、贫困(OR=0.79,95%CI:0.78-0.81)、病程较长(5-<10年组:OR=0.73,95%CI:0.70-0.75;10-<20年组:OR=0.72,95%CI:0.69-0.74;20-<30年组:OR=0.70,95%CI:0.68-0.73;30-80年组:OR=0.57,95%CI:0.55-0.60)、随访时间较长(1-<5年组:OR:0.47,95%CI:0.46-0.49;5-<10年组:OR=0.29,95%CI:0.28-0.30;10-12年组:OR=0.23,95%CI:0.12-0.45)、学历较高(初中、高中或中专组:OR=1.80,95%CI:1.76-1.84;大专及以上组:OR=2.27,95%CI:2.08-2.46)、城镇(OR=2.95,95%CI:2.87-3.03)、有家族精神病史(OR=1.19,95%CI:1.13-1.25)是服药依从性的影响因素。结论在控制地区聚集性后,中老年、男性、少数民族、学历较低者、农村、贫困、长病程、长随访时间、无家族精神病史的精神分裂症患者更容易不依从。Objective To explore the influencing factors of medication compliance in patients with schizophrenia in community.Methods Based on the basic information of patients with schizophrenia in the basic data collection and analysis system of severe mental disorders in a province,univariate analysis was conducted on individual factors and medication compliance of patients.A two-level logistic regression model was established based on patient level and city-state level,and the influencing factors of medication compliance of patients with schizophrenia in the province were analyzed.Results A total of 192099 patients with schizophrenia were included,of which 61656 had good medication compliance,with a compliance rate of 32.10%.The results of two-level logistic regression model showed that the influencing factors of medication compliance included:older age group(46 to<65 years:OR=0.78,95%CI:0.76-0.80;65 to 100 years:OR=0.57,95%CI:0.55-0.59),male(OR=0.85,95%CI:0.83-0.87),ethnic minorities(OR=0.71,95%CI:0.63-0.79),poverty(OR=0.79,95%CI:0.78-0.81),longer course of disease(5 to<10-year group:OR=0.73,95%CI:0.70-0.75;10 to<20-year group:OR=0.72,95%CI:0.69-0.74;20 to<30-year group:OR=0.70,95%CI:0.68-0.73;30 to 80-year group:OR=0.57,95%CI:0.55-0.60),long follow-up period(1 to<5-year group:OR=0.47,95%CI:0.46-0.49;5 to<10-year group:OR=0.29,95%CI:0.28-0.30;10-year group:OR=0.23,95%CI:0.12-0.45),higher educational level(junior high school,high school or secondary school group:OR=1.80,95%CI:1.76-1.84;college and above groups:OR=2.27,95%CI:2.08-2.46),town(OR=2.95,95%CI:2.87-3.03),and family history of mental illness(OR=1.19,95%CI:1.13-1.25).Conclusion After controlling regional clustering,schizophrenic patients with characteristics such as middle-aged,elderly,male,minority,lower educational level,rural areas,poverty,long course of disease,long follow-up period and no family history of mental illness are more likely to have poor compliance.

关 键 词：精神分裂症 服药依从性 多水平模型 

分 类 号：R749.3[医药卫生—神经病学与精神病学]