【作者】 余雅； 廖文平； 刘英； 吴波； 陈伟；

【Author】 Yu Ya;Liao Wenping;Liu Ying;Wu Bo;Chen Wei;Chongqing Institute of Tuberculosis Control and Prevention;National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention;

【机构】 重庆市结核病防治所； 中国疾病预防控制中心结核病预防控制中心；

【摘要】 目的了解重庆市贫困区(县)肺结核患者的的治疗依从性,并分析其影响因素,为制定相关干预措施提供依据。方法本研究选择重庆市黔江区、丰都县、开州区和巫山县作为项目区县,采用调查问卷对2019年1月至2020年6月间在4个区县定点医疗机构登记治疗的活动性肺结核患者的一般情况、服药情况、居住环境、诊疗费用及家庭经济情况等进行调查。对患者的治疗依从性进行分析,并采用Logistic回归模型分析相关影响因素。结果共纳入339例病例,治疗过程中有51.9%的患者出现过漏服药,其中34.2%的患者漏服药大于10%。漏服药的主要原因为忘记服药(45.5%)、经济困难(34.1%),不能耐受药物不良反应(27.8%)。年龄在15-29岁、治疗总费用低、居住地离定点医院距离近、参加医保和获得救助、得到社会支持和每日有人督导服药是治疗依从性的保护因素;而文化程度低、出现药物不良反应、家庭年收入低、医务人员的肺结核相关知识的宣教时间短是治疗依从性的危险因素。结论重庆市贫困区(县)肺结核患者的治疗依从率低。加强健康教育宣传、给予患者鼓励和支持、严格落实患者的督导管理、改善经济落后地区卫生资源状况和经济条件是改善治疗依从性的重要措施。更多还原

【Abstract】 Objective To investigate treatment adherence of pulmonary tuberculosis(PTB) patients and identify its influencing factors in economically undeveloped areas of Chongqing,to provide basis for the next step of developing relevant interventions.Methods A cross-sectional study was conducted in Qianjiang district,Fengdu county,Kaizhou district and Wushan county of Chongqing.A questionnaire was used to collected the information about social demographic characteristic,medication,living condition,medical expenditure,and family economic situation of active pulmonary TB patients registered from January 2019 to June 2020 in 4 designated TB hospitals.Analysis was conducted on the treatment adherence of TB patients,and influencing factors were analyzed by Logistic regression method.Results A total of 339 TB cases were included in this study.About 51.9 percent of TB patients had missed doses during the treatment,34.2 percent patients missed over 10% of the total prescribed doses.The main reasons of missing dose were forgetting to take medicine(45.5%),economic hardship(34.1%),and intolerance to adverse drug reactions(27.8%).Aged 15-29,low total medical cost,closer to designated TB hospitals,participation in health insurance and get health assistance,social support and daily directly observed treatment(DOT) were the protective factors for treatment adherence;however,low education level,adverse drug reactions,low family income,and short time to educate patients on TB knowledge were the risk factors.Conclusions The treatment adherence rate of TB patients in economically undeveloped districts and counties of Chongqing is low.Strengthening health education,giving encourage and support,implementing DOT,improving health resources and economic conditions in economically undeveloped areas are important measures to improve treatment adherence.更多还原