耐多药结核病患者治疗依从性的影响因素分析
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白丽琼

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R52R181.3+2

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全球基金和WHO资助课题(CHN/10/STB/005520)


Influencing factors for treatment compliance of patients with multidrugresistant tuberculosis
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    摘要:

    目的探讨耐多药结核(MDRTB)病患者出院后治疗依从性的影响因素。方法选择2011年11月—2013年1月到某结核病医院住院治疗的MDRTB病患者,出院后定期对患者进行电话回访,询问患者服药、复查等情况,分析影响MDRTB病患者治疗管理依从性的因素。结果299例患者纳入研究,治疗总依从率为81.94%(245例);规律服药者249例(83.28%),服药不规律者50例(16.72%);按时复查者254例(84.95%),未按时复查者45例(15.05%);中断治疗者37例(12.37%),调查截止日仍在继续治疗者260(86.96%)。单因素分析显示:治疗依从性(包括规律服药率、按时复查率、中断治疗率和总依从率)在不同年龄、文化程度、治疗时间,以及有无不良反应的MDRTB病患者中存在差异(均P<0.05)。logistic回归分析显示:MDRTB病患者治疗依从性与治疗时间(β=-1.47,Wald χ2=24.28,P<0.05)和不良反应(β=-2.02,Wald χ2=24.24,P<0.05)呈负相关,而与文化程度呈正相关(β=0.79,Wald χ2=6.50,P<0.05)。结论治疗时间延长和发生不良反应会降低MDRTB病患者治疗依从性,文化程度越高的MDRTB病患者治疗依从性越好。

    Abstract:

    ObjectiveTo investigate the influencing factors for postdischarge treatment compliance of patients with multidrugresistant tuberculosis (MDRTB). MethodsMDRTB patients who were hospitalized in a tuberculosis hospital between November 2011 and January 2013 were chosen, postdischarge followup was conducted regularly through telephone call. Medicinetaking  and reexamination of patients was inquired, factors influencing patients’ treatment compliance were analyzed.Results299 patients were included in the study,the total treatment compliance rate was 81.94% (n=245); 249(83.28%)patients regularly took medicine,50(16.72%) didn’t regularly take medicine; 254(84.95%)were reexamined on time,45(15.05%)were not reexamined on time; 37(12.37%)discontinued treatment,  260(86.96%) continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate, timely reexamination rate, interrupted treatment rate, and total compliance rate)was significantly different among MDRTB patients of different  ages, education levels, treatment time, and with or without adverse reactions(all P<0.05).Logistic regression analysis revealed that treatment compliance of MDRTB patients was negatively correlated with treatment time(β=-1.47,Wald χ2=24.28,P<0.05) and adverse reactions(β=-2.02,Waldχ2=24.24,P<0.05),while positively correlated with education levels(β=0.79,Wald χ2=6.50,p<0.05).ConclusionProlonged treatment time and adverse reactions can reduce the treatment compliance of MDRTB patients, the higher education levels of MDRTB patients have, the better treatment compliance they implement.

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李艳红,吴江贵,周桂芝,等.耐多药结核病患者治疗依从性的影响因素分析[J]. 中国感染控制杂志,2015,14(9):593-596. DOI:10.3969/j. issn.1671-9638.2015.09.004.
LI Yanhong, WU Jianggui, ZHOU Guizhi, et al. Influencing factors for treatment compliance of patients with multidrugresistant tuberculosis[J]. Chin J Infect Control, 2015,14(9):593-596. DOI:10.3969/j. issn.1671-9638.2015.09.004.

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  • 收稿日期:2015-03-06
  • 最后修改日期:2015-06-12
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  • 在线发布日期: 2015-09-30
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