文章摘要
姜悦,王晨,姜勇,潘岳松,李子孝.急性缺血性脑卒中及短暂性脑缺血发作二级预防药物依从性的社会学因素研究[J].中国临床保健杂志,2019,22(4):467-471.
急性缺血性脑卒中及短暂性脑缺血发作二级预防药物依从性的社会学因素研究
A study on the social factors of secondary prevention drug compliance in acute ischemic stroke and transient ischemic attack
投稿时间:2019-04-10  
DOI:10.3969/J.issn.1672-6790.2019.04.010
中文关键词: 卒中  脑缺血发作,短暂性  服药依从性  都市化  影响因素分析
英文关键词: Stroke  Ischemic attack,transient  Medication adherence  Urbanization  Root cause analysis 〖FL
基金项目:“十三五”国家重点研发计划(2017YFC1310901)
作者单位E-mail
姜悦 首都医科大学附属北京天坛医院,a 医务处,b 全科医疗科,c 神经病学中心,北京 100070 jiangyuettyy@139.com 
王晨 首都医科大学附属北京天坛医院,a 医务处,b 全科医疗科,c 神经病学中心,北京 100070 wangchen-tr2002@163.com 
姜勇 国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所  
潘岳松 国家神经系统疾病临床医学研究中心,北京脑重大疾病研究院脑卒中研究所  
李子孝 首都医科大学附属北京天坛医院,a 医务处,b 全科医疗科,c 神经病学中心,北京 100070  
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中文摘要:
      目的 探寻影响急性缺血性脑卒中(AIS)和短暂性脑缺血发作(TIA)二级预防药物依从性的现状社会学的相关因素,以期为提高我国缺血性脑卒中患者二级预防药物依从性提供建设性意见。方法 在全国219家医疗机构,2012年6月至2013年1月连续入组急性缺血性卒中和短暂性脑缺血发作的住院患者25 018例,对患者发病后3个月、6个月及12个月药物依从性进行随访。从2010年第六次全国人口普查数据及2013年各省市自治区统计公报数据中选取国内生产总值(GDP)、人均国内生产总值、城镇化率、非文盲率作为研究指标。分析缺血性卒中二级预防药物的药物依从性与上述指标之间的相关性。结果 最终16 489名AIS和TIA患者完成12个月的随访。中国缺血性脑卒中二级预防药物总体依从性3个月、6个月、12个月分别为47.0%、44.5%和34.9%。缺血性卒中二级预防药物总体依从性与区县的GDP、人均GDP与无显著差异;而与城镇化率呈正相关(P<0.001);与非文盲率呈负相关(P<0.05)。结论 城镇化建设有利于急性缺血性卒中二级预防药物依从性的提高。
英文摘要:
      Objective To investigate the degree of secondary prevention medications persistence after AIS or TIA associated with social factors.Methods From June 2012 to January 2013,5 018 patients with acute ischemic stroke or transient ischemic attack were admitted to 219 hospitals.The data of patients’ demographics,clinical features and medications use in secondary prevention at 3,6 and 12 months were collected.According to annual report on health statistics of China,Gross Domestic Product (GDP),per capita GDP,urbanization rate,the literacy rate and soon were selected from the 6th national population census in 2010 and China's National Bureau of Statistics in 2013 as social development factors to evaluate the relationship with medicine persistence.Multivariable logistic regression models using the generalized estimating equation method were used to identify patient/hospital factors/social independently associated with persistence of secondary prevention medications after AIS or TIA.Results Totally,16 489 patients were analyzed.The 3 month,6 month and 12 month of the persistence of secondary prevention medications were respectively 47.0%,44.5% and 34.9%.There was not significant difference between different GDP/per GDP and persistence at 3/6/12 month.With the increase in the level of urbanization rate,the persistence of secondary prevention medications increased(P<0.001).The literacy rate was negatively associated with the persistence(P<0.05).Conclusion Accelerating the urbanization process is positively associated with the improvement of the persistence.
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