上海市杨浦区社区中老年2型糖尿病患者服药依从性及其影响因素调查分析  

Medication compliance and influencing factors in middle-aged and elderly patients with type 2 diabetes mellitus in the community of Shanghai Yangpu District

作　　者：郭爱珍 金花[1,2,3,4] 茅俭波 朱卫红[6] 周晔 于德华 GUO Aizhen;JIN Hua;MAO Jianbo;ZHU Weihong;ZHOU Ye;YU Dehua(Department of General Practice,Yangpu Hospital,School of Medicine,Tongji University,Shanghai 200090,China;Academic Department of General Practice,School of Medicine,Tongji University,Shanghai 200090,China;Shanghai General Practice and Community Health Development Research Center,Shanghai 200090,China;Clinical Research Center for General Practice,Tongji University,Shanghai 200090,China;Changbai Community Health Service Center of Yangpu District,Shanghai 200093,China;Wujiaochang Community Health Service Center of Yangpu District,Shanghai 200433,China;Yanji Community Health Service Center of Yangpu District,Shanghai 200093,China)

机构地区：[1]同济大学附属杨浦医院全科医学科,上海200090 [2]同济大学医学院全科医学系,上海200090 [3]上海市全科医学与社区卫生发展研究中心,上海200090 [4]同济大学全科医学临床研究中心,上海200090 [5]上海市杨浦区长白社区卫生服务中心,上海200093 [6]上海市杨浦区五角场社区卫生服务中心,上海200433 [7]上海市杨浦区延吉社区卫生服务中心,上海200090

出　　处：《同济大学学报（医学版）》2023年第4期588-593,共6页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金青年项目(72104183)。

摘　　要：目的明确社区中老年2型糖尿病患者服药依从性水平并探讨其影响因素,为优化社区糖尿病管理策略提供参考。方法2021年11月—2022年1月,采用现况调查方法,从上海市杨浦区12个社区卫生服务中心随机抽样3个社区;对50岁及以上2型糖尿病患者进行面对面问卷调查,调查内容包括社会人口学、疾病状况、社会支持度及服药依从性等资料。采用SPSS 21.0软件进行服药依从性及其影响因素的单因素和多因素分析。结果共完成1138例有效问卷,其中1056例伴1种及以上其他慢性病(占92.79%);患者服药依从性评分平均为(6.18±1.59),评分≥6分者657例(57.7%),评分<6分者481例(42.3%)。多因素Logistic回归分析显示,年龄(OR=0.972,95%CI:0.9560.988,P<0.01)、共病数量(≥2种共病vs无共病:OR=0.652,95%CI:0.4300.988,P<0.05)、文化水平(初中vs小学及以下:OR=1.516,95%CI:1.0402.208,P<0.05;高中及以上vs小学及以下:OR=1.903,95%CI:1.2512.896,P<0.01)、社会支持(OR=1.060,95%CI:1.0371.083,P<0.01)等是服药依从性评分的独立影响因素。结论年龄越大,共病数量越多,服药依从性越低;文化水平越高,社会支持越高,服药依从性越高。开展个体化健康教育和提高社会支持度是改善患者服药依从性的重要策略。Objective To investigate medication compliance and its influencing factors in middle-aged and elderly patients with type 2 diabetes Mellitus(T2DM)in the community.Methods A cross-sectional study was conducted among T2DM patients age 50 years and above in 3 communities randomly selected in Shanghai Yangpu district from November 2021 to January 2022,The information of social demography,disease status,social support and medication compliance were collected by face-to-face interview.The medication compliance and its influencing factors were studied with univariate and multivariate Logistic analysis,and data were analyzed by SPSS 21.0 software.Results A total of 1138 valid questionnaires were received,and 1056 respondents(92.79%)had one or more comorbid chronic diseases.The average score of medication compliance was 6.18±1.585.There were 657(57.7%)cases with score of≥6 and 481(42.3%)cases with score of less than 6.Multivariate Logistic regression analysis showed that age(OR=0.972,95%CI:0.956-0.988,P<0.01),Comorbidity(with≥2 conditions vs no condition:OR=0.652,95%CI:0.430-0.988,P<0.05),education level(middle school vs primary school or below:OR=1.516,95%CI:1.040-2.208,P<0.05;high school or above vs primary school:OR=1.903,95%CI:1.251-2.896,P<0.01),social support(OR=1.060,95%CI:1.037-1.083,P<0.01)were independent influencing factors of medication compliance.Conclusion T2DM patients with older age and more comorbidities are likely to have a poorer medication compliance;while those with higher education and more social support are better in medication compliance.

关 键 词：2型糖尿病 社区 共病 服药依从性 社会支持 

分 类 号：R587.1[医药卫生—内分泌]