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慢性阻塞性肺疾病患者用药依从性模式及影响因素的横断面研究

A Cross-Sectional Study of Medication Adherence Pattern and Factors Affecting the Adherence in Chronic Obstructive Pulmonary Disease.

作者信息

Shrestha R, Pant A, Shakya Shrestha S, Shrestha B, Gurung R B, Karmacharya B M

机构信息

Department of Pharmacology School of Medical Sciences, Kathmandu University. Research & Development Division Dhulikhel Hospital, Kathmandu University Hospital.

Department of Pharmacology School of Medical Sciences, Kathmandu University. Department of Human Biology Schools of Science & Medical Sciences Kathmandu University.

出版信息

Kathmandu Univ Med J (KUMJ). 2015 Jan-Mar;13(49):64-70. doi: 10.3126/kumj.v13i1.13756.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is considered as a major health problem, associated with mortality and morbidities. Various disease management strategies have been established to optimize patient's longevity and functional status where patient adherence to the prescribed treatment plays a key role. Poor adherence to medication is common among COPD patients and is affected by number of factors like number of medicines, delivery devices and patient-related factors.

OBJECTIVE

This study aims to investigate the adherence pattern in the management of COPD and factors affecting patient adherence to the prescribed treatment.

METHOD

This study is a cross-sectional study which was conducted in a tertiary care hospital. Those patients suffering from COPD of all age were enrolled in this study and prior informed consent was obtained from patients. The structured questionnaire was used to interview those patients.

RESULT

Total 100 patients were enrolled in this study, among which most patients (45%) were of age groups 60-70 years. Unintentional non-adherence to medication attributed for 65% of patients and the major reason was forgetfulness (52.3%). Most patients had discontinued the medication due to experience of side effects (63.3%). The result showed significant association between adherence and polypharmacy (p=0.00). However, there was no significant association between adherence and age, sex, mode of administration of drugs, technics to use delivery devices etc.

CONCLUSION

Majority of COPD patients were elderly (mean age= 68.4 years). Forgetfulness was associated with medication non-adherence. Most of the patients had discontinued medication because of side effects. Polypharmacy is one of the major factors associated with non-adherence to medication in COPD.

摘要

背景

慢性阻塞性肺疾病(COPD)被视为一个主要的健康问题,与死亡率和发病率相关。已制定了各种疾病管理策略,以优化患者的寿命和功能状态,其中患者对规定治疗的依从性起着关键作用。COPD患者中药物依从性差很常见,并且受到多种因素的影响,如药物数量、给药装置和患者相关因素。

目的

本研究旨在调查COPD管理中的依从模式以及影响患者对规定治疗依从性的因素。

方法

本研究是在一家三级护理医院进行的横断面研究。所有年龄段的COPD患者均纳入本研究,并获得患者的事先知情同意。使用结构化问卷对这些患者进行访谈。

结果

本研究共纳入100例患者,其中大多数患者(45%)年龄在60 - 70岁之间。65%的患者存在无意的药物不依从,主要原因是遗忘(52.3%)。大多数患者因出现副作用而停药(63.3%)。结果显示依从性与多药治疗之间存在显著关联(p = 0.00)。然而,依从性与年龄、性别、药物给药方式、使用给药装置的技术等之间没有显著关联。

结论

大多数COPD患者为老年人(平均年龄 = 68.4岁)。遗忘与药物不依从相关。大多数患者因副作用而停药。多药治疗是COPD患者药物不依从的主要相关因素之一。

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