嘉南地區慢性阻塞性肺病患者藥物遵從行為之探討

Medication Adherence Among Patients with Chronic Obstructive Pulmonary Disease in Chia-Nan Area of Taiwan

背景與目的：慢性阻塞性肺病(COPD) 是全球死亡率遞增的慢性病之一。在醫療資源逐漸緊縮的時代，為使有限資源作最有效的運用，實有瞭解COPD 患者服藥現況與習性之必要。本研究探討嘉南地區慢性阻塞性肺病患者藥物遵從行為及其相關因素，以作為未來COPD 服藥衛教策略之參考。方法：本研究採橫斷式相關性研究，針對79 位年滿40 歲或以上之COPD 患者，進行居家訪視及結構性問卷量表調查。採用複迴歸分析患者之藥物遵從行為。結果：COPD 患者平均一週會有一天不按照醫囑服用藥物，86.1% 患者認為自己遵照醫師指示服藥。COPD 患者對疾病與藥物認識程度偏低，平均答對率為35.9%。嘉南地區COPD 患者之藥物遵從行為不會因年齡、性別、教育狀況、是否有他人協助服藥及吸菸狀況等有顯著差異，但與「共病症」呈負相關，並與「疾病認知」和「服藥總顆數」呈現正相關，解釋藥物遵從行為的總變異量為25%。結論：未來應加強COPD 患者對疾病、藥物及其共病症的認識，並簡化藥物顆粒數，以促進患者的藥物遵從行為。

Background and Objectives: The mortality related to chronic obstructive pulmonary disease (COPD) has been increasing worldwide. To ensure the effective use medical resources, it is important to understand the medication habits of patients with COPD. The purpose of this study was to assess the medication adherence of patients with COPD in Chia-Nan Area, Taiwan, and to identify factors influencing the same. Findings of this study may contribute to health education regarding medication strategies. Methods: This cross-sectional, correlational study included 79 patients with COPD, aged 40 years or more. Patients were interviewed during home visits, using a structured questionnaire. The factors affecting medication adherence in patients with COPD were assessed using a multiple regression analysis. Results: While 86.1% of the participants reported that they adhered to medication, on an average of once a week, they did not adhere to medication. They exhibited a low level of awareness regarding COPD and medication (mean correct answer rate = 35.9%). There were no significant differences in the medication adherence in terms of age, gender, education, whether or not assistance was needed during medication, or smoking. However, medication adherence was negatively associated with co-morbidity and positively correlated to disease perception and the total number of medicines consumed, and these variables explained 25% of the variance. Conclusions: To enhance COPD patients adherence to medication, it is necessary to improve their awareness of disease processes, medications, co-morbidity, and to simplify the complex prescription regimen and number of medicines prescribed.