基于行为经济学探究脊柱结核术后药物治疗依从性现状与影响因素  

Exploration of current situation and influencing factors of medication compliance after spinal tuberculosis

作　　者：杨良梅 YANG Liang-mei(Department of Orthopaedic Surgery,Henan Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院骨科普外科,郑州450000

出　　处：《医药论坛杂志》2025年第5期510-514,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210228)。

摘　　要：目的探究脊柱结核术后药物治疗依从性现状与影响因素,以及行为经济学对患者治疗依从性的影响。方法纳入2022年1月—2023年12月在河南省胸科医院接受治疗的74例脊柱结核术患者进行研究,进行社会人口学特征与疾病状况调查,并评估脊柱结核术后抗结核用药知识、行为经济学问卷、治疗依从性。依据治疗依从性将患者分为依从性良好组、依从性差组,分析治疗依从性影响因素。结果依从性良好患者54例(72.97%),依从性差患者20例(27.03%)。在年龄、文化程度、居住地、家庭月收入方面,两组患者有明显差异(P<0.05)。在共病数、既往抗结核治疗次数、耐多药、使用免费药物中,两组患者有明显差异(P<0.05)。依从性良好组患者的代表性认知偏差评分、默认选项评分、心理账户评分、社会规范评分、时间不一致偏好评分、风险偏好评分均高于依从性差组(P<0.05)。多因素logistic回归分析,年龄≥60岁、家庭月收入≤2000元、耐多药、未使用免费药物、默认选项、社会规范、时间不一致偏好是脊柱结核术患者治疗依从性的危险因素(P<0.05)。结论脊柱结核术患者药物治疗依从性较差,其危险因素包括年龄≥60岁、家庭月收入≤2000元、耐多药、未使用免费药物、默认选项、社会规范、时间不一致偏好。临床应当高度重视脊柱结核术患者的治疗依从性管理,尤其是有以上危险因素人群。Objective To explore the current situation and influencing factors of medication compliance after spinal tuberculosis,and the influence of behavioral economics on patient treatment compliance.Methods The study subjects were 74 patients with spinal tuberculosis treated in the Henan Chest Hospital from January 2022 to December 2023,who investigated the sociodemographic characteristics and disease status,and evaluated the knowledge of anti-tuberculosis medication,behavioral economics questionnaire,and compliance with treatment after spinal tuberculosis.Patients were divided into good adherence and poor adherence groups,and the influencing factors of treatment adherence were analyzed.Results There were 54 patients(72.97%)patients with good compliance and 20 patients(27.03%)patients with poor compliance.There were significant differences in age,educational level,residence,and monthly family income(P<0.05).There were significant differences in the number of comorbidities,number of previous anti-TB treatments,multi-drug resistance,and use of free drugs(P<0.05).Representative cognitive bias,default option,psychological account,social norms,time inconsistency preference,and risk preference were higher than those in the poor adherence group(P<0.05).In multivariate logistic regression analysis,age 60 years,a monthly household income of 2000 yuan,multidrug resistance,no free drugs,default options,social norms,and inconsistent time preferences were risk factors for treatment compliance in patients with spinal tuberculosis(P<0.05).Conclusion1 Patients with spinal tuberculosis have poor compliance with drug treatment,and their risk factors include age of 60 years,monthly family income of 2000 yuan,multidrug resistance,no free drugs.default options,social norms,and inconsistent time preferences.Clinical attention should be paid to the management of treatment compliance of spinal tuberculosis patients,especially those with the above risk factors.

关 键 词：行为经济学 脊柱结核术 抗结核化疗 治疗依从性 危险因素 

分 类 号：R687.3[医药卫生—骨科学]