摘要
目的:研究老年慢性病患者用药适宜性的关键影响因素及其作用关系,为相关研究提供参考。方法:通过文献回顾系统梳理老年慢性病患者用药适宜性的影响因素,以能力、机会、动机-行为(capacity,opportunity,motivation-behavior,COM-B)模型为分析框架进行整合。结果:纳入中文文献68篇、英文文献98篇。用药适宜性分为医生处方用药和患者自我用药两个层面,受到能力、机会和动机3类因素直接或间接的影响。医生处方用药适宜性的影响因素有专业技术水平、工作经验、处方习惯等能力因素,信息获取、学习机会、社会影响等机会因素,角色认知、自我效能、目标等动机因素。患者自我用药适宜性的影响因素有功能状态、知识水平、习惯等能力因素,信息获取、重要人物及经济支持等机会因素,疾病感知、对药物的态度等动机因素。结论:老年慢性病患者用药适宜性受到知识能力、内在心理、外部环境等多维度因素影响,应针对不同主体从多个维度构建用药适宜性的提升策略。
Objective:To study the key influencing factors and their relationship of medication appropriateness for elderly patients with chronic diseases,so as to provide references for relevant studies.Methods:The influencing factors of medication appropriateness for elderly patients with chronic diseases were systematically summarized through literature review,and the capacity,opportunity,motivation-behavior(COM-B) model was used as the analysis framework for integration.Results:68 Chinese literatures and 98 English literatures were included.Medication appropriateness was divided into two levels including doctors’ prescription medication and patients’ self-medication,which were directly or indirectly affected by three types of factors including ability,opportunity and motivation.The factors influencing the medication appropriateness of doctors’ prescription included ability factors such as professional skill level,work experience and prescription habit,opportunity factors such as information access,learning opportunities and social influence,and motivation factors such as role cognition,self-efficacy and goals.The influencing factors of appropriateness for patients’ self-medication included ability factors such as functional status,knowledge level and habit,opportunity factors such as information access,important people and economic support,and motivation factors such as disease perception and attitude towards drugs.Conclusion:The medication appropriateness for elderly patients with chronic diseases is affected by multi-dimensional factors such as knowledge ability,inner psychology and external environment,and the strategies for improving medication appropriateness should be constructed from multiple dimensions for different subjects.
作者
董忆晗
谢菡
李伯阳
DONG Yihan(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)
出处
《医学与社会》
北大核心
2022年第12期45-50,共6页
Medicine and Society
基金
教育部哲学人文社会科学研究项目,编号为13YJC630070
国家自然科学基金资助项目,编号为71804053。
关键词
合理用药
慢性病
老年人
用药适宜性
影响因素
Rational Use of Drug
Chronic Disease
Older Adult
Medication Appropriateness
Influencing Factor
