缺血性卒中患者服药依从性影响因素分析OA北大核心CSTPCD

Objective To investigate the influencing factors of medication adherence in ischemic stroke patients. Methods This prospective study consecutively included the ischemic stroke inpatients at the international department of Beijing Tiantan Hospital,Capital Medical University from June 2022 to December 2023.A questionnaire was used to collect information on patients'general information,medication adherence[evaluated by the Morisky medication adherence scale(MMAS)],perceived health competence[assessed by the perceived health competence scale(PHCS)],and stroke recurrence.The patients were divided into a poor adherence group(MMAS score＜6)and a medium-high adherence group(MMAS score≥6)based on their MMAS scores.The demographic characteristics,clinical features,and vascular risk factors of the two groups were compared,and the influencing factors of medication adherence were analyzed using multivariate logistic regression analysis. Results A total of 212 patients with ischemic stroke were included in this study,with a mean age of(59.9±5.9)years,and an MMAS score of 6(6-7),of whom 41 cases(19.34％)belonged to the poor adherence group and 171 cases(80.66％)belonged to the medium-high adherence group.The multivariate logistic regression analysis showed that the risk of poor compliance in patients with a junior high school education or below was 6.290 times higher than that of patients with a college degree or above(95％CI 1.912-20.689,P=0.002);the risk of poor adherence in patients without a spouse was 4.172 times higher than that of patients with a spouse(95％CI 1.372-12.684,P=0.012);the risk of poor compliance in unemployed patients was 4.115 times higher than that of employed patients(95％CI 1.326-12.773,P=0.014);and the risk of poor compliance in patients with low PHCS scores was 2.190 times higher than that of patients with moderate PHCS scores(95％CI1.098-4.370,P=0.026).Patients in the medium-high adherence group had higher follow-up completion rates at 1-month(99.42％vs.92.68％,P=0.004),3-month(98.83％vs.80.49％,P＜0.001)and 6-month(98.25％vs.75.61％,P＜0.001)after discharge than those in the low medication adherence group,and the difference was statistically significant.Meanwhile,the stroke recurrence rates of patients at 3-month(3.55％vs.12.12％,P=0.038)and 6-month(4.76％vs.16.13％,P=0.019)follow-up visits were lower than those of patients with low adherence,and the differences were statistically significant. Conclusions Patients with a junior high school education or below,without a spouse,unemployed,and with a low PHCS score are at a higher risk of poor medication adherence.Nursing staff should consider the individual differences of patients comprehensively,and develop and implement personalized health education plans to improve patients'medication adherence.