实体器官移植受者接受霉酚酸类药物TDM的意愿调查  

Investigation of patients’preferences regarding therapeutic drug monitoring of mycophenolic acid in solid organ transplantation

作　　者：刘爽 陈鸿圣 郭琦[1,2,3] 程吟楚 赵荣生 侯小飞[4] LIU Shuang;CHEN Hongsheng;GUO Qi;CHENG Yinchu;ZHAO Rongsheng;HOU Xiaofei(Dept.of Pharmacy,Peking University Third Hospital,Beijing 100191,China;Institute for Drug Evaluation,Peking University Health Science Center,Beijing 100191,China;Dept.of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Sciences,Peking University,Beijing 100191,China;Dept.of Urology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院药剂科,北京100191 [2]北京大学医学部药品评价中心,北京100191 [3]北京大学药学院药事管理与临床药学系,北京100191 [4]北京大学第三医院泌尿外科,北京100191

出　　处：《中国药房》2024年第1期90-94,共5页China Pharmacy

基　　金：国家自然科学基金项目(No.72074005)。

摘　　要：目的调查实体器官移植受者接受霉酚酸类(MPA)药物治疗药物监测(TDM)的意愿,并探究相关影响因素,为相关指南推荐意见形成及临床决策优化提供参考。方法采用横断面研究设计法,设计MPA TDM患者意愿调查问卷,选取2022年4月14日至2022年6月27日在北京市两家三级甲等综合医院接受MPA类药物治疗的实体器官移植受者进行调研。采用Likert 5级评分法对患者接受MPA TDM的意愿进行评分,采用Pearson相关分析和二元Logistic回归分析患者接受MPA TDM的意愿影响因素及其相关性,采用非参数检验和χ2检验对影响患者意愿决策的因素进行排序及一致性分析。结果共收集到有效问卷140份,有效回收率为77.35%。140例患者接受MPA TDM的平均意愿得分为(4.01±0.65)分,表明总体意愿值较高;有116例(82.86%)患者表示愿意或非常愿意接受MPA TDM;既往接受过TDM与未接受过TDM患者的意愿得分差异有统计学意义[(4.30±0.53)分vs.(3.80±0.65)分,P<0.001]。患者对MPA TDM的了解程度、重视程度与接受意愿呈显著正相关(P<0.001)。患者决策影响因素排序具有统计学上的一致性(P<0.001),影响程度由大到小分别为治疗有效性、安全性、舒适程度、经济性及时间成本。结论实体器官移植受者对MPA TDM的接受意愿较高,MPA TDM既往就诊经历和对MPA TDM的了解、重视程度为影响患者意愿的主要因素。OBJECTIVE To investigate the preferences of patients who underwent solid organ transplantation regarding therapeutic drug monitoring(TDM)of mycophenolic acid(MPA)and explore the factors influencing patients’decision-making process,so as to provide support for the development of individualized medication guidelines for MPA and improvement of clinical decision-making.METHODS The cross-sectional study was used to design the questionnaire on the patients’preferences to accept MPA TDM,and involved patients who underwent solid organ transplantation and received MPA treatment at two tertiary hospitals in Beijing from April 14,2022,to June 27,2022.The Likert 5-level scoring method was used to score the patients’preferences to accept MPA TDM,the influencing factors and their correlation of the patients’preferences to accept MPA TDM were analyzed by Pearson correlation analysis and binary Logistic regression analysis,and the nonparametric test and chi-square test were used to rank and analyze the consistency of the factors affecting patients’preference decision.RESULTS A total of 140 questionnaires were collected,and the effective recovery rate was 77.35%.The average preference score of 140 patients to receive MPA TDM was(4.01±0.65),and the overall preference value was high.There were 116(82.86%)patients agreed or strongly agreed with MPA TDM.Significant differences were observed in preference scores between patients who had previously undergone MPA TDM and those who had never undergone it[(4.30±0.53)scores vs.(3.80±0.65)scores,P<0.001].Additionally,patients’preference scores were significantly influenced by their understanding level and attention level(P<0.001).The ranking of factors contributing to decision-making exhibited consistency(P<0.001).The factors were ranked in descending order of clinical efficacy,safety,comfortability,economy and time cost.CONCLUSIONS The patients who underwent solid organ transplantation hold high preferences towards MPA TDM.The primary factors influencing their decisions are

关 键 词：霉酚酸类药物 治疗药物监测 患者意愿 实体器官移植 问卷调查 

分 类 号：R969.3[医药卫生—药理学] S857.134[医药卫生—药学]