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印度泰米尔纳德邦一家三级护理医院代谢综合征患者依从性差的原因探究:一项混合方法研究

Exploration of the Reasons for Poor Adherence Among Metabolic Syndrome Patients Attending a Tertiary Care Hospital in Tamil Nadu, India: A Mixed Method Study.

作者信息

Sarah Mathew Megan, M Vijayakarthikeyan, Saravanan Kavinkumar, Grace Angeline, P Angayarkanni

机构信息

Undergraduate, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Vinayaka Missions Research Foundation (Deemed to be University), Salem, Tamilnadu, IND.

Community Medicine, Vinayaka Mission's Kirupananda Variyar Medical College and Hospitals, Vinayaka Missions Research Foundation (Deemed to be University), Salem, Tamilnadu, IND.

出版信息

Cureus. 2024 Nov 29;16(11):e74753. doi: 10.7759/cureus.74753. eCollection 2024 Nov.

Abstract

Background A major challenge in the treatment of MetS is the prevalence of low rates of adherence to the treatment regimen for individual components by the affected persons. This study aimed to estimate the medication adherence level among those with metabolic syndrome, determine the factors significantly associated with low adherence to medication, and explore the reasons for poor adherence to medication Materials and methods This sequential explanatory type of mixed method study was conducted among the metabolic syndrome patients attending the lifestyle clinic of a tertiary care hospital in the Salem district of Tamil Nadu, India. For the quantitative component, 210 was the sample size and for the qualitative component, the sample size was six. Adherence to drugs was assessed using the Morisky Medication Adherence eight-item Scale (MMAS 8). Results The mean age of the participants was 56.6+11.5 years with a female preponderance of 108 (51.5%). Medication adherence was low in 90 (42.7%) participants. A high degree of adherence was noted only in 41 (19.4%) participants. Multilogistic regression analysis revealed that patients on both oral drugs and insulin, patients with higher perceived stress levels, and those on low levels of physical activity were significantly associated with poor adherence. Conclusion Regular counseling and reinforcement by the treating physician to improve adherence to medication at the grassroots level is important. Information, Education, and Communication and Behaviour Change Communication methods can be adopted to improve knowledge and to bring about a change in behavior in order to curb this problem.

摘要

背景

代谢综合征治疗中的一个主要挑战是患者对各个治疗方案组成部分的依从率较低。本研究旨在估计代谢综合征患者的药物依从性水平,确定与药物低依从性显著相关的因素,并探究药物依从性差的原因。材料与方法:本研究采用序列解释性混合方法,在印度泰米尔纳德邦塞勒姆区一家三级护理医院的生活方式诊所就诊的代谢综合征患者中进行。定量部分的样本量为210,定性部分的样本量为6。使用莫利斯基药物依从性八项量表(MMAS 8)评估药物依从性。结果:参与者的平均年龄为56.6±11.5岁,女性占优势,有108人(51.5%)。90名(42.7%)参与者的药物依从性较低。只有41名(19.4%)参与者的依从性较高。多逻辑回归分析显示,同时服用口服药物和胰岛素的患者、感知压力水平较高的患者以及身体活动水平较低的患者与依从性差显著相关。结论:治疗医生进行定期咨询和强化,以提高基层的药物依从性很重要。可以采用信息、教育和沟通以及行为改变沟通方法来提高知识水平并带来行为改变,以解决这个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/650d/11682708/c94fedfe1e23/cureus-0016-00000074753-i01.jpg

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