社区精神分裂症患者在 COVID-19 大流行期间的药物依从性：一项横断面研究。
Medication adherence among community-dwelling schizophrenia patients during the COVID-19 pandemic: A cross-sectional study.
机构信息
Foreign Affairs Office, North Sichuan Medical College, Nanchong, Sichuan, China.
Department of Psychiatric Rehabilitation, Nanchong Psychosomatic Hospital Affiliated to North Sichuan Medical College, Nanchong, Sichuan, China.
出版信息
Psychiatry Res. 2022 Nov;317:114841. doi: 10.1016/j.psychres.2022.114841. Epub 2022 Sep 9.
OBJECTIVES
This study aims to investigate medication adherence during the COVID-19 pandemic among community-dwelling schizophrenia patients, and to explore the role of social support in improving medication adherence in a rural community sample in China.
METHODS
A cross-sectional sample of 800 patients was recruited using a cluster random sampling method in Yingshan County, Sichuan Province. Information on participant demographic characteristics, social support and medication adherence was collected through face-to-face interviews. The data analysis was performed using SAS9.4. Two binary logistic regression models were employed to identify the association between regular medication use and social support.
RESULTS
The rate of regular medication adherence among community-dwelling patients with schizophrenia was 41.5%,which was lower than that indicated by recent research(Li et al., 2020) before COVID-19 in western rural China. The mean scores and standard deviation of the patient's objective support, subjective support, and support utilization were 4.94 ± 1.57, 17.03 ± 5.24, and 5.25 ± 2.75, respectively. The social support standard deviation was 27.22 ± 6.32. The crude odds ratio of objective support, subjective support, and support utilization were 0.790 (95%CI:0.713-0.876), 0.999 (95%CI:0.971-1.027), and 1.049 (95%CI:0.995-1.105) respectively. After adjusting for potential factors, the adjusted odds ratio of objective support, subjective support, and support utilization were 0.758 (95%CI:0.673-0.853), 1.030 (95%CI:0.994-1.068), and 1.043 (95%CI:0.985-1.105), respectively.
CONCLUSIONS
During the COVID-19 pandemic, community-dwelling schizophrenia patients had a low rate of regular medication adherence. This was particularly true of those who were older adults, less educated and living in rural areas. The results of this study suggest that strengthening social support may effectively improve medication adherence for those patients.
目的
本研究旨在调查 COVID-19 大流行期间社区精神分裂症患者的用药依从性，并探讨社会支持在改善中国农村社区样本中精神分裂症患者用药依从性方面的作用。
方法
采用整群随机抽样方法，在四川省英山县招募了 800 名患者进行横断面研究。通过面对面访谈收集参与者的人口统计学特征、社会支持和用药依从性信息。使用 SAS9.4 进行数据分析。采用二项逻辑回归模型分析社会支持与规律用药之间的关联。
结果
社区精神分裂症患者的规律用药依从率为 41.5%，低于 COVID-19 前（2020 年，Li 等）中国西部农村地区的研究结果。患者客观支持、主观支持和支持利用的平均得分和标准差分别为 4.94±1.57、17.03±5.24 和 5.25±2.75，社会支持标准差为 27.22±6.32。客观支持、主观支持和支持利用的粗比值比分别为 0.790（95%CI：0.713-0.876）、0.999（95%CI：0.971-1.027）和 1.049（95%CI：0.995-1.105）。调整潜在因素后，客观支持、主观支持和支持利用的调整比值比分别为 0.758（95%CI：0.673-0.853）、1.030（95%CI：0.994-1.068）和 1.043（95%CI：0.985-1.105）。
结论
COVID-19 大流行期间，社区精神分裂症患者的规律用药依从率较低，年龄较大、受教育程度较低和居住在农村地区的患者更为明显。本研究结果提示，加强社会支持可能有效提高患者的用药依从性。
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