张掖地区冠心病患者二级预防服药依从性及其相关因素的研究

目的调查张掖地区冠心病（CHD）患者二级预防用药依从性的现状及影响因素，并提出相应对策，以提高患者用药依从性。方法采用自行编制问卷调查方法，问卷内容包括患者一般情况和疾病资料，调查和分析张掖地区常住居民中616例CHD患者的二级预防用药依从性情况及其影响因素。结果616例CHD患者中，二级预防用药依从性好者仅62例，占10．1％。经单因素Logistic回归分析筛选关联变量，再用多因素Logistic回归分析进行影响因素分析，结果显示高收入家庭患者比低收人家庭依从性高，有配偶比无配偶者依从性高，服药种类少者比服药种类多者依从性高，出院时间短者比出院时间长者依从性高。结论张掖地区CHD患者二级预防用药依从性较低，加强社区医疗服务、提高CHD预防药物的报销比例、开发一些预防CHD的单片复方制剂，是提高CHD患者服药依从性的有效手段。

Study on medication compliance in secondary prevention of coronary heart disease patients and related factors in Zhangye district

Objective To survey the current status of patients, medication compliance in secondary prevention of coronary heart disease （CHD） in Zhangye district, analyze related influencing factors and propose relevant Methods A total of 616 CHD patients in constant residents of Zhangye district were surveyed. The medication compliance and influencing factors in secondary prevention of CHD patients were analyzed retrospectively by questionnaire survey. Results Among the 616 CHD patients, only 62 cases （ 10. 1% ） showed good medication compliance. The relative variables were screened through single factor Logistic regression analysis, and then the influencing factors were further analyzed by multiple factors Logistic regression analysis. Multiple factors Logistic regression analyses revealed that the medication compliance depended on the annual per-capita income, with or without spouses, drug categories and the latest discharging time. Conclusions The medication compliance of patients in CHD secondary prevention is poor in Zhangye district. Strengthening the community medical service, increasing the proportion of reimbursement about CHD prophylactic drugs and developing some monolithic compound preparation for prevention of CHD are effective means to improve the medication compliance of CHD patients.