绝经后妇女使用抗骨质疏松症药物的依从性及其影响因素分析

目的探讨影响绝经后妇女使用抗骨质疏松症药物依从性的相关因素。方法收集2010年3月～2011年3月至我院骨质疏松科初诊并经过双能X线检测确诊为骨质疏松症的绝经后妇女200例。从给入组对象处方抗骨质疏松症药物起,3个月、6个月、12个月进行随访,确定患者用药情况,对自行停药的患者询问其停药原因。此外,所有入组对象在初诊时完成患者一般情况的问卷调查,每次随访时完成有关疾病和药物评价的问卷调查,对问卷调查中的各项内容与患者在随访期间是否出现自行停药进行Logistic回归分析。结果患者在不同时间段内停药率和原因不相同,1年内的累积停药率高达35.0%。与停药相关因素有教育程度、起病症状、骨质疏松家族史、服用5种以上其他药物、骨质疏松症状改善、服药是否方便、药物副作用以及药物价格。结论绝经后妇女使用抗骨质疏松症药物治疗的依从性较差,可通过增加患者对于疾病和药物的了解和认知,加强老年病人用药的管理、对不同停药原因采取相应的措施以及识别停药高危人群来提高依从性。

The analysis of compliance of anti-osteoporosis drug use and the influential factors in postmenopausal women

Objective To explore the relative factors for the therapeutic compliance of drugs for the treatment of osteoporosis in postmenopausal women.Methods Clinical data of 200 postmenopausal women diagnosed with osteoporosis by dual energy absorptiometry in the prevention and treatment center of osteoporosis from March 2010 to March 2011 were collected.All included subjects were followed up for 3,6,and 12 months after the drug being administered.The status of drug use was determined.The reasons for drug discontinuation would be asked in withdrawal patients.Additionally,all subjects were investigated using the questionnaire of general condition at first consultation.The questionnaire of the disease evaluation should be completed at each follow-up.Logistic regression was used to evaluate every item in questionnaire and drug withdrawal.Results Withdrawal rate and reasons at different time period of the treatment were different.The cumulative discontinuation rate was 35.0% in 12 months.The relative factors for drug discontinuation included education,family history of osteoporosis,symptoms,more than 5 kinds of drugs used,relief,convenience,side effect,and cost.Conclusion The therapeutic compliance of anti-osteoporosis drug use in the postmenopausal women is poor.The compliance can be improved through increasing the knowledge of osteoporosis and drugs,strengthening the management of medication in elderly patients,taking appropriate measures for different withdrawal reasons,and identifying the patients with high-risk of withdrawal.