Progress on medication compliance of patients with multimorbidity in China
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摘要: 随着我国工业化、城镇化、人口老龄化进程不断加速,人们生产生活方式和疾病谱不断发生变化。心脑血管疾病、糖尿病、慢性呼吸系统疾病及癌症等为代表的慢性病的患病率逐年上升。慢性病已经取代传染病,成为威胁人类生命健康和生活质量的主要疾病。慢性病共存现象在社区老年人群中越来越常见。相较单一慢性病,共病的出现挑战了单病管理的基本原则,多种慢性病的相互作用也对人群造成更大的健康危害。慢性病共存多存在病情复杂、多重用药、过度医疗等问题,严重影响老年人的生活质量和期望寿命,加重家庭和社会的经济负担,增加国家医疗支出,造成卫生资源浪费。慢性病管理在改善患者健康结局、提升患者生活质量方面发挥了重要作用。而药物治疗是慢性病管理的重要内容,是控制病情、减少并发症的重要措施,也是患者预后和康复的有效手段。但是我国各地共病人群服药依从性存在差异,此现状增加了医务人员对共病患者的管理难度。本文依托于我国慢性病患者服药依从性现状,就社会经济学、疾病相关、患者相关、医护团队相关等影响因素展开分析,归类可改变因素,如患者的心理健康状态、认知水平、用药方案、医患沟通、医护的知识储备、药品价格等,进而探讨提高共病患者服药依从性的重要举措,最终为更好地管理共病患者提供借鉴。Abstract: With the acceleration of China's industrialization, urbanization and population aging process, people's production and life style and disease spectrum are constantly changing. The prevalence of chronic diseases represented by cardiovascular and cerebrovascular diseases, diabetes, chronic respiratory diseases and cancer has increased year by year. Chronic diseases have replaced infectious diseases as the major diseases that threaten human life, health and quality of life. The coexistence of chronic diseases is increasingly common in community elderly people. Compared with single chronic diseases, the emergence of comorbidities challenges the basic principles of monmorbidity management, and the interaction of multiple slow traffic diseases also causes greater health harm to the population. The coexistence of chronic diseases often has many problems, such as complex diseases, multiple drugs, and excessive medical treatment, which seriously affect the quality of life and life expectancy of the elderly, increase the economic burden of families and society, increase the national medical expenditure, and cause the waste of health resources. Chronic disease management plays an important role in improving patient health outcomes and improving their quality of life. Drug treatment is an important part of chronic disease management, an important measure to control the condition and reduce complications, and an effective means of patient prognosis and rehabilitation. However, there are differences in China, which increases the difficulty of medical staff to manage comorbid patients. This paper relies on the current situation of medication compliance with chronic diseases patients in China, the social economics, disease, patients, medical team related factors, such as patients' mental health status, cognitive level, medication plan, doctor-patient communication, medical knowledge reserve, drug prices, etc., and then discusses the important measures to improve the comorbid patients' medication compliance, finally provides reference for better management of comorbid patients.
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Key words:
- Chronic disease /
- Multimorbidity /
- Medication adherence /
- Influencing factors
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