北京城镇地区老年慢性病患者药物素养现状及影响因素分析:一项横截面调查  

Analysis of the Status and Influencing Factors of Medication Literacy Among Elderly Patients with Chronic Diseases in Urban Areas of Beijing:A Cross-sectional Survey

作　　者：金伟 国警月 周博雅 甄红娅 张微 武明芬 赵志刚[5] JIN Wei;GUO Jingyue;ZHOU Boya;ZHEN Hongya;ZHANG Wei;WU Mingfen;ZHAO Zhigang(Department of Pharmacy,Shangzhuang Town Community Health Service Center,Haidian District,Beijing 100094,China;Department of Pharmacy,Majiapu Community Health Service Center,Fengtai District,Beijing100068,China;Department of Pharmacy,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China;Office of the Fengtai District Community Health Service Management Center,Beijing 100071,China;Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]北京市海淀区上庄镇社区卫生服务中心药剂科,北京100094 [2]北京市丰台区马家堡社区卫生服务中心药剂科,北京100068 [3]首都医科大学附属北京妇产医院药事部,北京100006 [4]北京市丰台区社区卫生服务管理中心办公室,北京100071 [5]首都医科大学附属北京天坛医院药学部,北京100070

出　　处：《医药导报》2024年第12期1930-1936,共7页Herald of Medicine

基　　金：国家卫生健康委药具管理中心“药品使用说明书适老化研究项目”(国卫药管ZDC202201);国家卫生健康委医院管理研究所2023年医疗质量(循证)管理研究项目(YLZLXZ23G014)。

摘　　要：目的分析北京城镇地区老年慢性病患者药物素养的现状,明确其关键影响因素,并提出针对性的改善措施。方法2023年2月1日—6月30日,在北京市15个区县193个社区内,通过方便抽样方法,对老年慢性病患者进行问卷调查。采用面对面访谈的方式收集数据,共发放问卷787份,回收有效问卷755份,并运用logistic回归分析模型,系统识别并评估影响患者药物素养的各项因素。结果在回收755份有效问卷中,达到药物素养标准的患者比例为53.25%(402例)。回归分析结果显示,多项因素显著影响老年慢性病患者的药物素养,具体包括:采用农村合作医疗或自费支付方式(OR=1.669,P=0.039)、保留药品说明书(OR=0.519,P=0.038)、用药前查看药品说明书(OR=1.993,P<0.01)以及具备理解药品说明书的能力(部分理解OR=2.805,P=0.038;完全理解OR=3.084,P=0.022)为正向影响因素;而患有2或3种慢性病(OR=0.574,P=0.039)、服用3~5种药物(OR=1.845,P=0.015)和存在用药问题(OR=1.993,P<0.01)则构成负向影响因素。结论老年慢性病患者的药物素养受多重因素综合影响。建议采取针对性措施,如修订与年龄相适应的患者用药指导说明书、提高患者对药品说明书的理解能力、加强用药指导与社会支持,从而保障老年患者的用药安全与疗效。Objective To analyze the current state of medication literacy among elderly patients with chronic diseases in urban areas of Beijing,identify its key influencing factors,and propose targeted improvement measures.Methods From February 1 to June 30,2023,a questionnaire survey was conducted among elderly chronic disease patients in 193 communities across 15 districts of Beijing using a convenience sampling method.Data was collected through face-to-face interviews,with a total of 787 questionnaires distributed and 755 valid responses received.The logistic regression analysis model was employed to systematically identify and evaluate the factors affecting patients'medication literacy.Results Among the 755 valid questionnaires collected,53.25%(402 cases)of patients met the medication literacy criteria.Regression analysis results showed that multiple factors significantly influenced medication literacy among elderly patients with chronic diseases,including using rural cooperative medical care or self-payment methods(OR=1.669,P=0.039),retaining medication instructions(OR=0.519,P=0.038),checking medication instructions before use(OR=1.993,P<0.01),and possessing the ability to understand medication instructions(partial understanding OR=2.805,P=0.038;fully understanding OR=3.084,P=0.022)as positive influencing factors;whereas having 2 to 3 chronic diseases(OR=0.574,P=0.039),taking 3 to 5 medications(OR=1.845,P=0.015),and experiencing drug-related problems(OR=1.993,P<0.01)were identified as negative influencing factors.Conclusion Multiple factors influence medication literacy among elderly patients with chronic diseases.To ensure the safety and efficacy of their medication use,It is recommended to implement targeted measures.These include revising patient medication guidance leaflets tailored to age,enhancing patients'understanding of drug instructions,and strengthening medication guidance and social support systems.

关 键 词：药物素养 老年人 慢性病 影响因素 问卷调查 

分 类 号：R95[医药卫生—药学]