Liu Dan, Qiu Linghe, Han Lu, Wang Yajing, Wang Fei, Liu Xiaowei, Wu Jianhong
Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China.
Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
BMC Public Health. 2024 Dec 18;24(1):3521. doi: 10.1186/s12889-024-20939-2.
To evaluate the medication-related burden (MRB) of patients with late-life depression (LLD) and its influencing factors in China using the Living with Medicines Questionnaire-3 (LMQ-3), providing reference for reducing the MRB of those patients.
A cross-sectional study was conducted between September 2023 and January 2024 on 588 patients with LLD. LMQ-3 and MRB factors questionnaire were used for data collection. The distribution of variables was assessed using descriptive analysis, while analyses of Mann-Whitney and Kruskal-Wallis were performed to evaluate inter-group differences. To explore the MRB among patients with LLD and influencing factors, multiple linear regression analysis was performed.
The median (IQR) LMQ-3 score of 588 participants was 102 (18), indicating a moderate MRB level. Regression analysis revealed a significant trend toward higher perceived burden among patients aged 70-79 years old, living in rural areas, receiving more medical insurance settlements, using all cash, taking more than 5 drugs each time, and taking medicine more than 3 times a day (p < 0.05), which were risk factors for higher MRB. Conversely, patients who lived with their children, had an annual household income (including adult children) more than 50,000 Chinese Yuan, and no adverse drug reactions had lower LMQ-3 scores (p < 0.05), which were protective factors. Patients' concerns about medicine, their lack of autonomy in medicine regimens, and the lack of communication between patients and doctors on treatment regimens were the main causes of the burden.
Results of this study provided preliminary evidence of the MRB among patients with LLD. Age, residence, living status, annual household income, type of drug payment, quantity and frequency of medication, and adverse reactions significantly affected the perceived medication burden. It is advisable for health policy makers and health care providers to implement appropriate intervention strategies and burden reduction programs for this vulnerable group.
采用药物生活问卷-3（LMQ-3）评估中国老年抑郁症（LLD）患者的药物相关负担（MRB）及其影响因素，为减轻这些患者的MRB提供参考。
于2023年9月至2024年1月对588例LLD患者进行了一项横断面研究。使用LMQ-3和MRB因素问卷进行数据收集。采用描述性分析评估变量分布，同时进行Mann-Whitney和Kruskal-Wallis分析以评估组间差异。为探讨LLD患者的MRB及其影响因素，进行了多元线性回归分析。
588名参与者的LMQ-3得分中位数（IQR）为102（18），表明MRB水平为中等。回归分析显示，年龄在70 - 79岁、居住在农村地区、获得更多医保结算、使用全现金支付、每次服用超过5种药物以及每天服药超过3次的患者，其感知负担有显著升高趋势（p < 0.05），这些是MRB升高的危险因素。相反，与子女同住、家庭年总收入（包括成年子女）超过5万元且无药物不良反应的患者，其LMQ-3得分较低（p < 0.05），这些是保护因素。患者对药物的担忧、用药方案缺乏自主性以及患者与医生在治疗方案上缺乏沟通是负担的主要原因。
本研究结果为LLD患者的MRB提供了初步证据。年龄、居住地点、生活状况、家庭年总收入、药物支付类型、用药数量和频率以及不良反应显著影响了感知药物负担。建议卫生政策制定者和医疗服务提供者针对这一弱势群体实施适当的干预策略和减负计划。
