慢性乙型肝炎患者免费恩替卡韦服药依从性水平调查(1)
[摘要] 目的 调查慢性乙型肝炎患者免费恩替卡韦服药依从性水平现状。 方法 以2012年6月~2016年4月参加湖北省中医院临床研究的免费服用恩替卡韦的慢性乙型肝炎患者401例为对象,随访48周,根据患者服药日志记录卡记录的服药量及药物回收量进行调查及质量控制,评估患者用药依从性水平。 结果 慢性乙型肝炎患者24、36周依从性优于12、48周(P < 0.01)。1年依从性水平为98.4%,完全依从占32.0%,依从性>95% d的占92.4%。乙肝肝硬化患者依从性优于慢性乙型肝炎(轻、中度)患者(P < 0.01)。漏服药物的主要原因为遗忘。 结论 尽管慢性乙型肝炎患者免费恩替卡韦服药依从性水平较高,但患者对疾病认知仍存在不足,需加强患者对疾病的认知教育,提高依从性。
[关键词] 慢性乙型肝炎;恩替卡韦;抗病毒;依从性
[中图分类号] R512.62 [文献标识码] A [文章编号] 1673-7210(2017)12(b)-0037-04
[Abstract] Objective To investigate status of the medication compliance of patients with chronic hepatitis B receiving free Entecavir. Methods A total of 401 patients with chronic hepatitis B receiving free Entecavir and participated in the clinical study of Hubei Provincial Hospital of Traditional Chinese Medicine from June 2012 to April 2016 were taken as objects, followed-up for 48 weeks, the investigation and quality control was conducted according to the dose of drug use and the amount of drug recovery from the patients' medication log card, so as to evaluate the medication compliance of patients. Results The medication compliance of 24, 36 weeks in patients with chronic hepatitis B was better than those of 12, 48 weeks (P < 0.01). The compliance rate of one year was 98.4%, full compliance was accounted for 32.0%, and the percentage of compliance >95% d was 92.4%. The medication compliance of patients with hepatitis B cirrhosis was better than that of mild to moderate chronic hepatitis B (P < 0.01). The main reason of missing drugs was forgotten. Conclusion Although the medication compliance of patients with chronic hepatitis B receiving free Entecavir is high, but the patients still lack the knowledge about the disease. It is necessary to strengthen the patients' cognitive education of the disease and improve the compliance.
[Key words] Chronic hepatitis B; Entecavir; Antiviral; Compliance
我國是慢性乙型肝炎病毒(HBV)感染的高发区,核苷(酸)类药物(NAs)能快速有效地减少乙肝病毒脱氧核糖核酸(HBV DNA)的合成,但不能彻底清除HBV在复制过程中形成的共价闭合环状DNA(cccDNA)模板[1]。大部分慢性乙型肝炎(CHB)患者,尤其是HBeAg阴性CHB和乙肝肝硬化患者,需要长期抗病毒治疗[2]。长期抗病毒治疗患者往往出现漏服药物或自行停药、自行延长服药间隔时间、自行减量等情况[3]。而药物依从性不仅与耐药发生有关,还与抗病毒治疗的疗效有关[1]。药物依从性指患者的用药行为与医嘱的一致性,通常用一段时间内患者实际用药量占该段时间规定用药量的百分比来表示[4]。由于医疗数据来源有限,我国尚无恩替卡韦(ETV)抗病毒治疗患者药物依从性水平(以下简称“依从性”)的大样本研究报道,本研究拟调查CHB患者免费服用ETV的依从性,分析未按时服药的原因,以期为提高长期服药依从性提供一定的参考和依据。
1 对象与方法
1.1 研究对象
采用便利抽样法,选取2012年6月~2016年4月参加湖北省中医院肝病研究型门诊临床研究并给予免费ETV治疗的CHB患者401例作为研究对象。纳入标准:①诊断符合《慢性乙型肝炎防治指南》(2010年版)[5];②无重叠感染其他病毒性肝炎;③签署知情同意书。排除标准:药物性肝病,自身免疫性肝炎,肝癌,免疫缺陷,妊娠妇女,严重心脑血管、肺、肾、内分泌和造血系统严重原发性疾病,精神病患者。, 百拇医药(陶军秀 李晓东 万长秀)
[关键词] 慢性乙型肝炎;恩替卡韦;抗病毒;依从性
[中图分类号] R512.62 [文献标识码] A [文章编号] 1673-7210(2017)12(b)-0037-04
[Abstract] Objective To investigate status of the medication compliance of patients with chronic hepatitis B receiving free Entecavir. Methods A total of 401 patients with chronic hepatitis B receiving free Entecavir and participated in the clinical study of Hubei Provincial Hospital of Traditional Chinese Medicine from June 2012 to April 2016 were taken as objects, followed-up for 48 weeks, the investigation and quality control was conducted according to the dose of drug use and the amount of drug recovery from the patients' medication log card, so as to evaluate the medication compliance of patients. Results The medication compliance of 24, 36 weeks in patients with chronic hepatitis B was better than those of 12, 48 weeks (P < 0.01). The compliance rate of one year was 98.4%, full compliance was accounted for 32.0%, and the percentage of compliance >95% d was 92.4%. The medication compliance of patients with hepatitis B cirrhosis was better than that of mild to moderate chronic hepatitis B (P < 0.01). The main reason of missing drugs was forgotten. Conclusion Although the medication compliance of patients with chronic hepatitis B receiving free Entecavir is high, but the patients still lack the knowledge about the disease. It is necessary to strengthen the patients' cognitive education of the disease and improve the compliance.
[Key words] Chronic hepatitis B; Entecavir; Antiviral; Compliance
我國是慢性乙型肝炎病毒(HBV)感染的高发区,核苷(酸)类药物(NAs)能快速有效地减少乙肝病毒脱氧核糖核酸(HBV DNA)的合成,但不能彻底清除HBV在复制过程中形成的共价闭合环状DNA(cccDNA)模板[1]。大部分慢性乙型肝炎(CHB)患者,尤其是HBeAg阴性CHB和乙肝肝硬化患者,需要长期抗病毒治疗[2]。长期抗病毒治疗患者往往出现漏服药物或自行停药、自行延长服药间隔时间、自行减量等情况[3]。而药物依从性不仅与耐药发生有关,还与抗病毒治疗的疗效有关[1]。药物依从性指患者的用药行为与医嘱的一致性,通常用一段时间内患者实际用药量占该段时间规定用药量的百分比来表示[4]。由于医疗数据来源有限,我国尚无恩替卡韦(ETV)抗病毒治疗患者药物依从性水平(以下简称“依从性”)的大样本研究报道,本研究拟调查CHB患者免费服用ETV的依从性,分析未按时服药的原因,以期为提高长期服药依从性提供一定的参考和依据。
1 对象与方法
1.1 研究对象
采用便利抽样法,选取2012年6月~2016年4月参加湖北省中医院肝病研究型门诊临床研究并给予免费ETV治疗的CHB患者401例作为研究对象。纳入标准:①诊断符合《慢性乙型肝炎防治指南》(2010年版)[5];②无重叠感染其他病毒性肝炎;③签署知情同意书。排除标准:药物性肝病,自身免疫性肝炎,肝癌,免疫缺陷,妊娠妇女,严重心脑血管、肺、肾、内分泌和造血系统严重原发性疾病,精神病患者。, 百拇医药(陶军秀 李晓东 万长秀)