目的:本研究旨在探讨慢性阻塞性肺疾病(COPD)稳定期患者雾化吸入药物治疗(IDT)依从性的影响因素。
方法:选取2022年4月至2022年10月在我院呼吸科慢性病门诊就诊的COPD稳定期患者243例作为研究对象,采用便利抽样法。通过问卷调查收集所有参与者的相关信息进行调查。包括基本信息,临床特征,吸入药物的名称,态势感知,剂量和频率。
结果:单因素分析显示以下因素之间呈正相关:(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,客观支持和支持利用,(2)用药依从性总分和COPD-Q总分,客观支持和支持利用以及(3)技术标准化总分和社会支持总分,主观支持和客观支持(p<0.05)。多因素分析表明,COPD健康素养,过去一年的急性加重次数和社会支持因素合计占患者对IDT依从性变量的37.4%,COPD健康素养也是如此,改良医学研究理事会(mMRC)分级,COPD的持续时间,支持的利用和婚姻状况共同占患者剂量依从性变量的47.4%。年龄的健康,mMRC分级,社会支持,居住模式,过去一年的急性加重次数和患者吸入技术标准化程度为47.4%.
结论:剂量依从性主要受COPD健康素养的影响,mMRC分级,COPD的持续时间,利用支持和婚姻状况。吸入技术标准化受到年龄的限制,mMRC分级,社会支持,居住模式,过去一年的急性恶化次数和识字率。
OBJECTIVE: This study aimed to investigate the influential factors of adherence to inhalation drug therapy (IDT) in patients with stable chronic obstructive pulmonary disease (COPD).
METHODS: 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.
RESULTS: 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%.
CONCLUSIONS: 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.