社区老年糖尿病人群抗糖尿病药物的利用情况、依从性及影响因素

目的了解实际自然人群中老年糖尿病患者抗糖尿病药物的分布和使用情况,评价老年糖尿病人群药物治疗依从性并探讨其影响因素。方法利用社区老年糖尿病人群抗糖尿病药物的用药监测系统,统计各类抗糖尿病药物的使用情况和依从性;对依从性的影响因素进行非条件logistic回归分析。结果监测社区老年糖尿病3 040例,未服药197例(占6．48％),不规则服药1 836例(占60．39％),规则服药1007例(占33．13％,口服降糖药物治疗936例,胰岛素治疗71例;单一服药614例,联合服药393例);单独服用格列齐特218例,单独服用二甲双胍111例,单独服用格列吡嗪91例,单独服用其他药物194例;格列齐特与二甲双胍联合服用124例,格列吡嗪与二甲双胍联合服用76例,其他药物联合服用193例。结论社区老年人群抗糖尿病药物服药依从性低。发病时间长、接受糖尿病知识教育、经常监测血糖、非药物治疗是不规则服药的主要独立保护因素,嗜甜食、医疗费支付有困难、空腹血糖控制不良是不规则服药的主要独立危险因素;发病时间长、有糖尿病家族史、经常监测血糖是未服药的主要独立保护因素,空腹血糖控制不良、低级别医疗购药渠道是未服药的主要独立危险因素。

Antidiabetic drugs utilization, compliance and relevant factors in elderly diabetic patients in Shanghai community

AIM To assess the profile of antidiabetic drugs utilization and compliance of the elderly diabetes mel-litus (DM) in Shanghai community and to screen the possible risk factors. METHODS By cluster sampling from five administrative areas of Shanghai, the sample size was 3 259 subjects with clinically diagnosed elderly DM. A door-to-door retrospectively pharmacoepidemiological survey was conducted and we established a monitoring system of antidiabetic drugs in elderly diabetic population in Shanghai. We investigated the utilization and compliance of antidiabetic drugs and identified possible risk factors in logistic regression. RESULTS A total of 3 040 subjects (1 913 females and 1 127 males) with clinically diagnosed elderly DM were finally enrolled in the study, dropout rate was 7.20% . The number of not taking medicine, taking medicine irregularly and taking medicine regularly was 197(6.48% ) , 1 836(60.39%) and 1 007(33. 13%) respectively. CONCLUSION The compliance of antidiabetic drugs in elderly diabetic population is low. Long course of disease, receiving DM education, monitoring blood sugar regularly, non-pharmacological treatment are main independent protective factors, and addicted sweetmeat, difficult to pay medical cost and bad level of fasting plasma glucose (FPG) are main independent risk factors of taking medicine irregularly in elderly DM. Long course of dis- ease, having familial history, monitoring blood sugar regularly are main independent protective factors, and purchasing drugs at junior distinction, bad level of FPG, diabetic macrovascular complications are the risk factors of not taking medicine in elderly DM.