紧密型医联体多中心老年维持性血液透析病人磷结合剂服药依从性调查及其相关因素分析

doi:10.3969/j.issn.1003-9198.2022.04.002

摘要/Abstract

摘要： 目的调查紧密型医联体多中心老年维持性血液透析(MHD)病人磷结合剂服药依从性状况并探讨其影响因素。方法选取2020年6~12月在我院3个紧密联系型血液净化中心行MHD的老年病人,采用调查问卷收集其一般资料、磷结合剂用药依从性、血磷和血钙水平,采用多元Logistic回归分析磷结合剂用药依从性的影响因素。结果共312例病人完成有效调查问卷(有效回收率为95.4%)。其中磷结合剂服药依从性好组252例(70.8%),依从性差组60例(19.2%),服药依从性好组血磷达标率明显高于服药依从性差组(P<0.05)。单因素和多因素Logistic回归分析结果显示,病人透析龄、原发病种类是影响病人磷结合剂用药依从性的独立危险因素(P＜0.05)。医联体内部3个透析中心老年病人磷结合剂服药依从性情况比较,本部中心依从性明显高于2个分中心(P＜0.05), 但2个分中心间比较差异无统计学意义(P>0.05)。结论老年MHD病人磷结合剂服药依从性有待进一步提高,病人透析龄、原发病种类是影响其磷结合剂用药依从性的独立危险因素。

关键词: 磷结合剂, 维持性血液透析, 紧密型医联体, 用药依从性

Abstract: Objective To investigate the characteristics and influencing factors of the medication adherence to phosphorus binding agent in the elderly patients undergoing maintenance hemodialysis(MHD) in the close-type medical association. Methods The elderly patients who were treated in three dialysis centers of close-type medical association in our hospital from June to December 2020 were enrolled. The patients were investigated by general information questionnaire, simplified medication compliance questionnaire and laboratory indicators, and the relevant influencing factors of medication adherence were analyzed. Results A total of 327 patients were surveyed and 312 patients completed, the effective recovery was 95.4%. Out of the patients, 252 cases(70.8%) had good adherence to phosphorus binding agent, and 60 patients(19.2%) had poor compliance. The blood phosphorus control rate in the good compliance group was significantly higher than that in the poor compliance group. Logistic regression analysis showed that dialysis age and primary diseases were the influencing factors of medication compliance(P<0.05). The medication compliance in the center was significantly higher than that in the two subcenters(P<0.05), but there was no significant difference between the two subcenters(P>0.05). Conclusions The adherence to phosphorus binding agent in the elderly MHD patients needs to be further improved. The dialysis age and the primary diseases in the elderly patients are the independent risk factors affecting the adherence to phosphorus binding agent.

Key words: phosphorus binding agent, maintenance hemodialysis, close-type medical association, medication adherence

中图分类号:

R 459.5

谢庆磊, 张留平, 王越, 李梦婷, 王彬. 紧密型医联体多中心老年维持性血液透析病人磷结合剂服药依从性调查及其相关因素分析[J]. 实用老年医学, 2022, 36(4): 328-332.

XIE Qing-lei, ZHANG Liu-ping, WANG Yue, LI Meng-ting, WANG bin. Study on the status and influencing factors of medication adherence to phosphorus binding agent in elderly patients undergoing maintenance hemodialysis in close-type medical association[J]. Practical Geriatrics, 2022, 36(4): 328-332.

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