CAJ | 학술논문

目的：调查不同等级医院缺血性脑卒中（IS）患者二级预防用药依从性的现状及影响因素。方法采用访谈形式，收集我院（三级医院）IS患者出院1.5年来二级预防用药情况；收集同期在北京万寿路社区医院（一级医院）门诊处方的IS患者1.5年来二级预防用药情况。结果154例我院IS患者中，抗血小板聚集、降脂药的依从性分别为72.7%、49.3%，合并高血压、糖尿病患者降压、降糖药依从性分别为77.6%、70.3%；167例社区IS患者中，抗血小板聚集、降脂药的依从性分别为79.0%、29.9%，合并高血压、糖尿病患者降压、降糖药依从性分别为93.2%、96.6%。结论IS患者二级预防中抗血小板、降脂、降压、降糖药物的应用都未达标，其中降脂药依从性依从性最差，社区医院尤为明显。三级医院和社区医院IS患者二级预防用药依从性存在差异，医疗付费方式、医生未予处方分别是三级医院及社区医院影响依从性独立危险因素。
목적：조사불동등급의원결혈성뇌졸중（IS）환자이급예방용약의종성적현상급영향인소。방법채용방담형식，수집아원（삼급의원）IS환자출원1.5년래이급예방용약정황；수집동기재북경만수로사구의원（일급의원）문진처방적IS환자1.5년래이급예방용약정황。결과154례아원IS환자중，항혈소판취집、강지약적의종성분별위72.7%、49.3%，합병고혈압、당뇨병환자강압、강당약의종성분별위77.6%、70.3%；167례사구IS환자중，항혈소판취집、강지약적의종성분별위79.0%、29.9%，합병고혈압、당뇨병환자강압、강당약의종성분별위93.2%、96.6%。결론IS환자이급예방중항혈소판、강지、강압、강당약물적응용도미체표，기중강지약의종성의종성최차，사구의원우위명현。삼급의원화사구의원IS환자이급예방용약의종성존재차이，의료부비방식、의생미여처방분별시삼급의원급사구의원영향의종성독립위험인소。
Objective To investigate secondary prevention drug adherence of ischemic stroke(IS)patients in different levels of hospital and the influential factors of it. Methods Using interview form to collect medication data of IS patients during the period of 1.5 year,who were discharged from our hospital;and at the same time collect IS patients with ischemic stroke 1.5 year who were given prescriptions in Wanshou Road community hospital. Results In 154 cases patients of our hospital,the adherence of anti-platelet aggregation,lipid-lowering drugs was 72.7%,49.3%respectively,and the adherence of antihypertensive,antidiabetic drug were 77.6%,70.3%to patients with hypertension and diabetes. In 167 cases patients of community hospital,the adherence of anti-platelet aggregation,lipid-lowering drugs was 79.0%,29.9% respectively,and the adherence of antihypertensive,antidiabetic drug were 93.2%,96.6%%to patients with hypertension and diabetes. Conclusion The drug adherence of IS patients with antiplatelet,lipid-lowering,antihypertensive,hypoglycemic drug were substandard,and the adherence of lipid-lowering drug is the worst,community hospitals especially.There were differences about the drug adherence of IS patients between tertiary hospital and community hospital.The medical payment method was independent risk factor affecting drug adherence of patients.The main reasons for poor adherence of community patients is not prescripted.