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重庆市某社区老年慢性病患者对处方精简态度的调查研究
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| 篇名： | 重庆市某社区老年慢性病患者对处方精简态度的调查研究 |
| TITLE： | |
| 摘要： | 目的：为促进处方精简的顺利实施提供依据。方法：随机抽取重庆市某社区卫生服务中心所辖的4个社区和9个村卫生室所辖区域的老年慢性病患者335例，就受访者的一般情况、患病及用药情况以及对处方精简的态度进行问卷调查和统计、分析。问卷以澳大利亚“患者对于处方精简的态度”问卷为依据，其中患者认知功能情况使用长谷川痴呆量表，患者虚弱程度使用中文版埃德蒙顿虚弱评估量表，患者生命质量使用中文版欧洲五维健康量表（EQ-5D）进行评估。结果：得到有效问卷311份，有效回收率为92.8％。311例老年慢性病患者的中位年龄为70岁；中位疾病数为5种，以高血压最为常见；中位用药种数为5种，以钙通道阻滞药、非胰岛素类降糖药为主；多重用药人数占54.7％（170人）。对于处方精简的态度方面，39.5％的受访者认为目前所用药品太多，73.9％的受访者希望减少目前所用的药物，83.6％的受访者表示如果医师同意，愿意实施处方精简；多重用药患者较非多重用药患者更希望少用药（P＝0.001）并减少目前使用的药品（P＝0.001），更愿意通过减少用药来降低药费（P＝0.008），也更担心药物副作用（P＝0.005）。结论：社区老年慢性病患者多病共存、多重用药现象普遍，实施处方精简非常必要。多数老年患者愿意在医师同意下进行处方精简，且多重用药患者较非多重用药患者更愿意实施处方精简。 |
| ABSTRACT： | OBJECTIVE： To provide reference for promoting smoothly implementation of deprescribing. METHODS： A total of 335 elderly patients with chronic disease were randomly selected from 4 communities and 9 village clinic of a Chongqing community health service center. Questionnaire survey was conducted about general information of respondents， disease and drug use condition and attitude to deprescribing by using Australian Patients’ Attitudes Towards Deprescribing questionnaire as reference. The results of questionnaire survey were analyzed statistically. The cognitive function was assessed by Hastgawa Dementia Scale. The degree of weakness was evaluated by Chinese edition of Edmonton Frail Scale. The quality of life was evaluated by Chinese edition of European Five Dimensional Health （EQ-5D） Scale. RESULTS： Totally 311 valid questionnaires were obtained， with effective recovery rate of 92.8％. Overall， 311 participants were recruited， with a median age of 70 years， 5 types of median disease （hypertension was most common） and 5 types of median medication （mainly calcium channel blocker and non-insulin hypoglycemic agent）； 54.7％（170 cases） participants took multiple drugs. The attitudes towards deprescribing were that 39.5％ of respondents believed that they took too many drugs； 73.9％ had a desire to reduce their drugs； 83.6％ reported that they would be willing to reduce drugs if their doctor said it was possible. The patients taking multiple drugs preferred to use less drugs （P＝0.001） and reduce current drugs （P＝0.001）， and were more willing to reduce drug cost by reducing drug use； they were also more worried about drug side effects than those without taking multiple drugs （P＝0.005）. CONCLUSIONS： The phenomenon of elderly chronic diseases patients with multiple diseases and multiple drug use are popular in community. It is necessary to simpilfy prescription. Most elderly patients would like to reduce their medications if doctors say it is possible； the patients with multiple drug use are more willing to simplify prescription than those without multiple drug use. |
| 期刊： | 2018年第29卷第10期 |
| 作者： | 张莎，蒙龙，杨佳丹，罗玲，邱峰 |
| AUTHORS： | ZHANG Sha，MENG Long，YANG Jiadan，LUO Ling，QIU Feng |
| 关键字： | 老年患者；慢性病；社区；多重用药；处方精简；患者态度 |
| KEYWORDS： | Elderly patients； Chronic disease； Community； Multiple drug use； Deprescribing； Patient’s attitude |
| 阅读数： | 374 次 |
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