Chen Yi-Chun, Leu Hsieh-Shong, Wu Shu-Fang, Wu Yen-Mu, Wang Tsae-Jyy
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Division of Infectious Diseases, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.
Hu Li Za Zhi. 2015 Feb;62(1):58-67. doi: 10.6224/JN.62.1.58.
Taking antibiotics in strict adherence to physician prescriptions is crucial for maintaining the stability of the drug concentration in the blood and for achieving the best therapeutic effects. The increasing antimicrobial resistance in recent decades has led the Ministry of Health and Welfare to promote the rational use of antibiotics and the use of a computer monitoring system to control the use of antibiotics in hospitals. Although non-adherence is considered as the major factor contributing to antimicrobial resistance, patient non-adherence to antibiotic prescriptions is an issue that has been largely overlooked. This paper explores this issue due to the serious threat from antimicrobial resistance and the few studies that have investigated patient adherence to antibiotic treatments for acute infections in Taiwan.
The aims of the study include: (1) describe patient's adherence to antibiotic therapy for acute infections and (2) explore the potential factors of influence on antibiotic adherence such as demographics, disease characteristics, and knowledge of antibiotic treatment.
The study used a descriptive correlational design. A convenience sample of 162 patients with acute infections was recruited from outpatient infectious disease clinics in Taoyuan City. Data were collected using the study questionnaire and analyzed using the chi-square test, Mann-Whitney U test, and logistic regression.
The study results showed that only 40.1% of patients followed their prescription to take antibiotics completely. The remainder earned lower scores than their prescription-adhering counterparts for knowledge regarding the effects of antibiotics (U = 2654.5, p = .046). Results of logistic regression showed that knowledge regarding the effects of antibiotics was the most significant predictor (B = .481, p = .046) of adherence to antibiotic therapies.
Non-adherence to prescriptions is prevalent in short-term antibiotic treatments prescribed for acute infections. This finding reminds healthcare providers to provide proper education to the recipients of antibiotic treatments, even those treated for a very short duration for acute infections in outpatient settings. Special attention should be pay to enhancing the understanding and appreciation of patients for the therapeutic effects of antibiotics.
严格按照医生处方服用抗生素对于维持血液中药物浓度的稳定以及实现最佳治疗效果至关重要。近几十年来，抗菌药物耐药性不断增加，促使卫生福利部推动抗生素的合理使用，并使用计算机监测系统来控制医院抗生素的使用。尽管不依从被认为是导致抗菌药物耐药性的主要因素，但患者对抗生素处方的不依从问题在很大程度上被忽视了。由于抗菌药物耐药性带来的严重威胁以及台湾地区针对急性感染患者抗生素治疗依从性的研究较少，本文对这一问题进行了探讨。
本研究的目的包括：（1）描述急性感染患者对抗生素治疗的依从性；（2）探讨影响抗生素依从性的潜在因素，如人口统计学特征、疾病特征和抗生素治疗知识。
本研究采用描述性相关性设计。从桃园市门诊传染病诊所招募了162例急性感染患者作为便利样本。使用研究问卷收集数据，并采用卡方检验、曼-惠特尼U检验和逻辑回归进行分析。
研究结果显示，只有40.1%的患者完全按照处方服用抗生素。其余患者在抗生素作用知识方面的得分低于依从处方的患者（U = 2654.5，p = .046）。逻辑回归结果显示，抗生素作用知识是抗生素治疗依从性的最显著预测因素（B = .481，p = .046）。
在为急性感染开具的短期抗生素治疗中，不依从处方的情况普遍存在。这一发现提醒医疗保健提供者，即使是在门诊环境中接受急性感染短期治疗的患者，也应为其提供适当的教育。应特别注意提高患者对抗生素治疗效果的理解和认识。
