医院门诊慢性病老年人用药依从性调查分析

摘要

目的:了解医院门诊慢性病老年人用药依从性现状及影响因素,探讨今后针对医院门诊老年人药学服务的重点.方法:以问卷调查方式,对2010年5月～10月到我院门诊就诊的60岁以上患慢性病的老年人进行调查.结果:在645份有效问卷中,评价为依从性佳者占81.2%,依从性不佳者占18.8%.用药不依从原因主要包括:忘记服药(57.2%)、顾忌不良反应(43.9%)、品种多记不清用法用量(33.3%)、认为自己病情好转(28.5%)、不清楚不依从用药的影响(23.4%)、医师没交待用法用量(17.4%)、更相信食物疗法(10.5%)、经济原因(9.6%)、药师没交待用法用量(9.5%)、认为自己不用吃药(9.1%)等.提高用药依从性的影响因素包括:医师交待清楚用药原因(54.7%)、选用不良反应少的药品(45.1%)、选用疗效更好的药品(44.2%)、选用用药次数少的药品(35.2%)、药师交待清楚用法用量(31.9%)、医师交待清楚用法用量(28.5%)、减少用药品种(23.9%)、可以方便与药师沟通(21.2%)、药品更经济(17.5%)、可以方便与医师沟通(16.9%)等.结论:药师交待并标注清楚药品的用法用量、医药知识的普及与指导、构建和完善方便患者与药师沟通的途径、构筑良好的医患关系等是当前及今后医院门诊药学服务的重点,尤其是对老年人.%Objective:Understanding hospital outpatient chronic disease status and influence factors of elderly patients with medication compliance,focus of discussion for hospital outpatient pharmacy services for the elderly in the future.Methods:To questionnaire surveys,between May 2010 and my hospital patient suffering from chronic diseases of the elderly over 60 years of investigation. Results:645 valid questionnaires,evaluation of compliance with good accounting for 81.2%,accounted for 18.8 percent of poor compliance. Medication non-compliance the main reasons include:Forgot medication (57.2%),fear of adverse reactions (43.9%),don't remember the usage of varieties (33.3%),consider themselves in a better condition (28.5%),not clear non-compliance from the use of drugs (23.4%),physicians did not explain the usage and consumption (17.4%),believes food therapy (10.5%),economic reasons (9.6%),did not explain the usage of licensed pharmacists (9.5%),consider themselves not to take medicines (9.1%),etc. Improving medication compliance of influencing factors include:Doctor explains clearly the medication reason (54.7%),select fewer adverse drug (45.1%),choose the effect of better medicines (44.2%),use of less frequent dosing of drugs (35.2%),pharmacists a clear picture of usage and consumption (31.9%),physicians made clear dosage and administration (28.5%),reduce the number of drug varieties (23.9%),you can easily communicate with pharmacists (21.2%),pharmaceuticals (17.5%) and more economical,you can easily communicate with physicians (16.9%),etc. Conclusion:Pharmacist to explain and marked clearly drug dosage,popularization of medical knowledge and guidance,building and perfecting ways to facilitate patient and pharmacist communication,build a good doctor-patient relationship is the focus of current and future outpatient pharmacy services,especially for the elderly.