Zheng Li, Sun Haiyan, Chen Qi, Xie Xin, Jin Hong, Ding Ye
Department of Surgery, The People's Hospital of SND, Suzhou, China.
Department of Respiratory, The People's Hospital OF SND, Suzhou, China.
J Eval Clin Pract. 2025 Feb;31(1):e14094. doi: 10.1111/jep.14094. Epub 2024 Aug 2.
This study aimed to investigate the influential factors of adherence to inhalation drug therapy (IDT) in patients with stable chronic obstructive pulmonary disease (COPD).
A total of 243 patients with stable COPD who visited the chronic disease clinic of the respiratory department of our hospital between April 2022 and October 2022 were selected as participants using the convenience sampling method. Relevant information about all participants was collected by questionnaire for investigation, including basic information, clinical characteristics, inhaled drug names, situational awareness, dose and frequency.
Univariate analysis revealed positive correlations between the following factors: (1) the total score of drug adherence and the total scores of the COPD knowledge questionnaire (COPD-Q), social support, subjective support, objective support and support utilisation, (2) the total score of dosage adherence and the total scores of COPD-Q, objective support and support utilisation and (3) the total score of technical standardisation and the total scores of social support, subjective support and objective support (p < 0.05). Multifactorial analysis showed that COPD health literacy, number of acute exacerbations in the past year and social support factors collectively accounted for 37.4% of the variable of patient adherence to IDT, as did COPD health literacy, modified Medical Research Council (mMRC) grading, duration of COPD, utilisation of support and marital status collectively account for 47.4% of the variable of patient dosage adherence. The goodness-of-fit of age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy to the patients' inhalation technical standardisation in the model was 47.4%.
Dose adherence was predominantly influenced by COPD health literacy, mMRC grading, duration of COPD, utilisation of support and marital status. Inhalation technical standardisation was substantially limited by age, mMRC grading, social support, mode of residence, number of acute exacerbations in the past year and literacy.
本研究旨在调查稳定期慢性阻塞性肺疾病(COPD)患者吸入药物治疗(IDT)依从性的影响因素。
采用便利抽样法,选取2022年4月至2022年10月期间到我院呼吸内科慢性病门诊就诊的243例稳定期COPD患者作为研究对象。通过问卷调查收集所有研究对象的相关信息,包括基本信息、临床特征、吸入药物名称、情境意识、剂量和频率。
单因素分析显示,以下因素之间存在正相关:(1)药物依从性总分与COPD知识问卷(COPD-Q)总分、社会支持、主观支持、客观支持及支持利用度;(2)剂量依从性总分与COPD-Q总分、客观支持及支持利用度;(3)技术标准化总分与社会支持、主观支持及客观支持总分(p<0.05)。多因素分析表明,COPD健康素养、过去一年急性加重次数和社会支持因素共同占患者IDT依从性变量的37.4%,COPD健康素养、改良医学研究委员会(mMRC)分级、COPD病程、支持利用度和婚姻状况共同占患者剂量依从性变量的47.4%。模型中年龄、mMRC分级、社会支持、居住方式、过去一年急性加重次数和文化程度对患者吸入技术标准化的拟合优度为47.4%。
剂量依从性主要受COPD健康素养、mMRC分级、COPD病程、支持利用度和婚姻状况的影响。吸入技术标准化在很大程度上受年龄、mMRC分级、社会支持、居住方式、过去一年急性加重次数和文化程度的限制。