我国社区2型糖尿病患者治疗依从性对临床产出的短期影响研究
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篇名: 我国社区2型糖尿病患者治疗依从性对临床产出的短期影响研究
TITLE:
摘要: 目的:为提高我国社区2型糖尿病患者的治疗依从性和治疗效果提供参考。方法:利用北京大学中国卫生经济研究中心“中国糖尿病药物经济学研究”课题组的随访数据,以随访终点糖化血红蛋白(HbA1c)水平作为临床产出指标,对终点HbA1c水平进行二分类变量和数值变量的单因素分析和多元回归分析,以评价治疗依从性对短期临床产出的影响。结果:本次研究共纳入2 236例社区2型糖尿病患者,用药依从性好和差的患者分别占23.48%和76.52%;血糖监测依从性好和差的患者分别占7.02%和93.98%;饮食控制依从性好、中和差的患者分别占66.3%、23.5%和10.2%。单因素分析结果表明,血糖“控制好”组与血糖“控制差”组在患者年龄、身体质量指数、文化程度、病程、是否锻炼、饮食习惯等方面存在显著性差异(P<0.05)。多元Logistic回归和多元对数线性回归模型的分析结果相似,即患者血糖监测依从性和饮食控制依从性对终点HbA1c水平有显著的积极影响(均P<0.05),但是用药依从性的影响不显著(P>0.05)。结论:我国2型糖尿病患者的治疗依从性总体上不理想。在控制其他变量的影响之后,患者治疗依从性对终点HbA1c水平有积极的影响,尤其是血糖监测依从性和饮食控制依从性的改善将有利于血糖控制,而用药依从性的影响则不明显。
ABSTRACT: OBJECTIVE: To provide reference for improving the treatment compliance and therapeutic effect of patients with type 2 diabetes mellitus (T2DM) in China. METHODS: The follow-up data was from the issue of Pharmacoeconomic Study of Diabetic Drugs in China, which was conducted by China Center for Health Economic Research (CCHER) of Peking University. Using follow-up endpoint HbA1c level as clinical output indicator, univariate analysis and multivariable regression analysis of binary and numerical variables were performed to evaluate the effect of treatment compliance on short-term clinical outcomes. RESULTS: Totally 2 236 community T2DM patients were included for the analysis. The patients with good and poor medication compliance accounted for 23.48% and 76.52%; the patients with good and poor blood glucose monitoring compliance accounted for 7.02% and 93.98%; 66.3%, 23.5% and 10.2% of the patients had good, medium and poor diet control compliance, respectively. Univariate analysis showed that there was a significant difference in the “good control” group of blood glucose and the “poor control” group of blood glucose in terms of patient age, body mass index, education level, duration of disease, exercise, and eating habits,etc (P<0.05). Similar results were obtained in the analysis of multiple Logistic regression and multivariate loglinear regression models, that is, blood glucose monitoring compliance and diet control compliance had significant positive effects on end-point HbA1c (P<0.05), but drug compliance had no significant effect (P>0.05). CONCLUSIONS: The treatment compliance among community patients with T2DM in China was generally poor. After controlling for other variables, patients’ treatment compliance has a positive effect on end-point HbA1c, especially better blood glucose monitoring compliance and diet control compliance contribute to blood glucose control, but medication compliance has no significantly effect.
期刊: 2019年第30卷第18期
作者: 李洪超,官海静,刘国恩
AUTHORS: LI Hongchao,GUAN Haijing,LIU Guo’en
关键字: 2型糖尿病;用药依从性;血糖监测依从性;饮食控制依从性;糖化血红蛋白
KEYWORDS: Type 2 diabetes mellitus; Medication compliance; Blood glucose monitoring compliance; Diet control compliance; HbA1c
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