CAJ | 학술논문

目的了解实际自然人群中老年糖尿病患者抗糖尿病药物的分布和使用情况,评价老年糖尿病人群药物治疗依从性并探讨其影响因素.方法利用社区老年糖尿病人群抗糖尿病药物的用药监测系统,统计各类抗糖尿病药物的使用情况和依从性;对依从性的影响因素进行非条件logistic回归分析.结果监测社区老年糖尿病3 040例,未服药197例(占6.48%),不规则服药1 836例(占60.39%),规则服药1 007例(占33.13%,口服降糖药物治疗936例,胰岛素治疗71例;单一服药614例,联合服药393例);单独服用格列齐特218例,单独服用二甲双胍111例,单独服用格列吡嗪91例,单独服用其他药物194例;格列齐特与二甲双胍联合服用124例,格列吡嗪与二甲双胍联合服用76例,其他药物联合服用193例.结论社区老年人群抗糖尿病药物服药依从性低.发病时间长、接受糖尿病知识教育、经常监测血糖、非药物治疗是不规则服药的主要独立保护因素,嗜甜食、医疗费支付有困难、空腹血糖控制不良是不规则服药的主要独立危险因素;发病时间长、有糖尿病家族史、经常监测血糖是未服药的主要独立保护因素,空腹血糖控制不良、低级别医疗购药渠道是未服药的主要独立危险因素.
목적 료해실제자연인군중노년당뇨병환자항당뇨병약물적분포화사용정황,평개노년당뇨병인군약물치료의종성병탐토기영향인소.방법 이용사구노년당뇨병인군항당뇨병약물적용약감측계통,통계각류항당뇨병약물적사용정황화의종성;대의종성적영향인소진행비조건logistic회귀분석.결과 감측사구노년당뇨병3 040례,미복약197례(점6.48%),불규칙복약1 836례(점60.39%),규칙복약1 007례(점33.13%,구복강당약물치료936례,이도소치료71례;단일복약614례,연합복약393례);단독복용격렬제특218례,단독복용이갑쌍고111례,단독복용격렬필진91례,단독복용기타약물194례;격렬제특여이갑쌍고연합복용124례,격렬필진여이갑쌍고연합복용76례,기타약물연합복용193례.결론 사구노년인군항당뇨병약물복약의종성저.발병시간장、접수당뇨병지식교육、경상감측혈당、비약물치료시불규칙복약적주요독립보호인소,기첨식、의료비지부유곤난、공복혈당공제불량시불규칙복약적주요독립위험인소;발병시간장、유당뇨병가족사、경상감측혈당시미복약적주요독립보호인소,공복혈당공제불량、저급별의료구약거도시미복약적주요독립위험인소.
AIM To assess the profile of antidiabetic drugs utilization and compliance of the elderly diabetes mellitus (DM) in Shanghai community and to screen the possible risk factors. METHODS By cluster sampling from five administrative areas of Shanghai, the sample size was 3 259 subjects with clinically diagnosed elderly DM. A door-to-door retrospectively pharmacoepidemiological survey was conducted and we established a monitoring system of antidiabetic drugs in elderly diabetic population in Shanghai. We investigated the utilization and compliance of antidiabetic drugs and identified possible risk factors in logistic regression. RESULTS A total of 3 040 subjects ( 1 913 females and 1 127males) with clinically diagnosed elderly DM were finally enrolled in the study, dropout rate was 7.20 %. The number of not taking medicine, taking medicine irregularly and taking medicine regularly was 197 (6.48 % ), 1 836(60.39% ) and 1 007(33.13%)respectively. CONCLUSION The compliance of antidiabetic drugs in elderly diabetic population is low. Long course of disease, receiving DM education, monitoring blood sugar regularly, non-pharmacological treatment are main independent protective factors, and addicted sweetmeat, difficult to pay medical cost and bad level of fasting plasma glucose (FPG) are main independent risk factors of taking medicine irregularly in elderly DM. Long course of dis ease, having familial history, monitoring blood sugar regularly are main independent protective factors, and purchasing drugs at junior distinction, bad level of FPG, diabetic macrovascular complications are the risk factors of not taking medicine in elderly DM.