江苏省淮安市耐多药肺结核患者服药依从性及影响因素分析

目的:探讨江苏省淮安市耐多药肺结核(multidrug-resistant pulmonary tuberculosis,MDR-PTB)患者服药依从性现状及其影响因素。方法:选择2017年1月至2019年6月期间诊断并纳入江苏省淮安市结核病定点医院治疗的235例MDR-PTB患者作为研究对象,采用Morisky服药依从性量表(Morisky medication adherence scale,MMAS-8)进行调查,分析MDR-PTB患者服药依从性现状及其影响因素。结果:235例患者中,197例(83.8%)服药依从性良好,38例(16.2%)服药依从性差。logistic多因素分析结果显示,男性(OR=2.526,95%CI:1.217~4.524)、年龄≥60岁(OR=1.521,95%CI:1.025~2.693)、有药物不良反应(OR=3.892,95%CI:1.793~6.822)、自服药(OR=2.635,95%CI:1.466~6.107)、病程≥2年(OR=1.529,95%CI:1.112~2.453)、流动人口(OR=2.868,95%CI:1.559~5.234)、受教育程度在初中及以下(OR=1.297,95%CI:1.009~1.615)、家庭月收入<5000元(OR=1.493,95%CI:1.265~5.392)的人群服药依从性较差。结论:应针对男性、年龄≥60岁、有药物不良反应、自服药、病程≥2年、流动人口、受教育程度在初中及以下、家庭月收入<5000元的MDR-PTB患者开展有针对性的健康宣教和用药指导。

Analysis of drug compliance and influencing factors of patients with multidrug-resistant pulmonary tuberculosis in Huai’an,Jiangsu Province

Objective:To investigate the current situation and influencing factors of drug compliance of patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB) in Huai ’an, Jiangsu Province. Methods:A total of 235 MDR-PTB patients diagnosed and treated in the designated tuberculosis hospital in Huai’an, Jiangsu Province from January 2017 to June 2019 were selected, and the Morisky medication adherence scale (MMAS-8) was used for investigation to analyze the current status and influencing factors of drug compliance of MDR-PTB patients. Results:Among the 235 patients, 197 patients (83.8%) had good drug compliance, and 38 patients (16.2%) had poor drug compliance. The results of logistic multivariate analysis showed that male (OR=2.526, 95%CI: 1.217-4.524), aged ≥60 years (OR=1.521, 95%CI: 1.025-2.693), adverse drug reactions (OR=3.892, 95%CI: 1.793-6.822), self-taking medicine (OR=2.635, 95%CI: 1.466-6.107), duration of disease ≥2 years (OR=1.529, 95%CI: 1.112-2.453), floating population (OR=2.868, 95%CI: 1.559-5.234), education background of junior high school or below (OR=1.297, 95%CI: 1.009-1.615), family monthly income OR=1.493, 95%CI: 1.265-5.392) were risk factors of drug compliance. Conclusion:Targeted health education and medication guidance should be carried out for MDR-PTB patients who were male and aged ≥60 years old, with adverse drug reactions and self-administration, and the disease duration ≥2 years, furthermore, those who were floating population, with education background of junior high school or below, and monthly household income