摘要
目的探究中老年慢性病患者服药依从性现状及其影响因素,构建并验证风险预测模型,为提升中老年慢性病患者服药依从性提供借鉴。方法采取便利抽样法,选取2023年9月—2024年4月在皖南医学院第一、第二附属医院的1030名中老年慢性病患者为研究对象。采用一般资料调查表、服药依从性量表、衰弱量表、社会衰弱量表、主观认知功能量表,分析中老年慢性病患者服依从性的影响因素,构建并验证风险预测模型。结果1030名中老年慢性病患者中服药依从性好者515(50.0%)名。单因素分析结果显示,不同居住地、自理程度、衰弱、社会衰弱、主观认知功能是服药依从性的影响因素(P<0.05)。多因素logistic回归分析显示,衰弱(OR=1.970)、社会衰弱(OR=1.559)、主观认知功能下降(OR=2.141)是中老年慢性病患者服药依从性的危险因素(P<0.05)。基于上述的危险因素构建列线图预测模型,H-L检验中χ^(2)=1.418,P=0.710,ROC曲线下面积为0.671(95%CI:0.639~0.703);校准曲线显示模型预测发生概率与实际发生概率一致性良好;决策曲线显示模型具有较好的实用性。结论构建的风险预测列线图模型具有较好的预测价值,可为中老年慢性病患者的服药依从性的干预提供一定的参考意见。
Objective To explore the status and influencing factors of medication compliance in middle-aged and elderly patients with chronic diseases,and to construct and validate a risk prediction model,so as to provide reference for improving the medication compliance in this population.Methods A total of 1030 middle-aged and elderly patients with chronic diseases in the First and Second Affiliated Hospitals of Wannan Medical College from September 2023 to April 2024 were selected as the research subjects by convenient sampling method.General information questionnaire,medication adherence report scale(MARS),the FRAIL scale,social frailty scale and subjective cognitive decline questionnaire(SCD-Q9)were used to analyze the influencing factors of compliance in them,and the risk prediction model was constructed and verified.Results Among 1030 middle-aged and elderly patients with chronic diseases,515(50.0%)had good medication compliance.Univariate analysis showed that place of residence,degree of self-care,frailty(OR=1.970),social frailty(OR=1.559),subjective cognitive decline(OR=2.141)were the influencing factors of medica-tion compliance(P<0.05).Multivariate logistic regression analysis showed that frailty,social frailty,and subjective cognitive decline were risk factors for medication compliance in these patients(P<0.05).Based on the above risk factors,a risk prediction nomogram prediction model was constructed.In Hosmer-Lemeshow test,χ^(2)=1.418,P=0.710,the area under the curve(AUC)of the receiver operating characteristic(ROC)was 0.671(95%CI:0.639~0.703).The calibration curve fits well;the decision curve shows that the model has good practicability.Conclusion The constructed risk prediction nomogram model has good predictive value,which can provide some reference for the interven-tion of medication compliance in middle-aged and elderly patients with chronic diseases.
作者
邵明
董奥奇
刘欢
潘玲玲
徐勤
陶秀彬
周志庆
SHAO Ming;DONG Aoqi;LIU Huan;PAN Lingling;XU Qin;TAO Xiubin;ZHOU Zhiqing(Graduate School of Wannan Medical College,Wuhu 241002,China;Blood Purification Center,The First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu 241001,China;Department of Cardiology,The First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu 241001,China;Department of Intervention,The First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu 241001,China;Department of Nursing,The First Affiliated Hospital of Wannan Medical College(Yijishan Hospital),Wuhu 241001,China)
出处
《济宁医学院学报》
2025年第1期32-37,共6页
Journal of Jining Medical University
基金
安徽省新时代育人质量工程项目(2022jyjxggyj338)
芜湖市科技计划项目(2020rkx4-5)
皖医弋矶山医院管理与服务创新项目(CX2022013)。
关键词
中老年慢性病
服药依从性
预测模型
Middle-aged and elderly chronic diseases
Medication compliance
Predictive model
作者简介
通信作者:周志庆,E-mail:1274467404@qq.com。
