| 杨春松,宋虹漪,张伶俐,韩璐.中国儿童癫痫患者用药依从性现状和影响因素研究[J].中国药事,2017,(12):1513-1521 |
| 中国儿童癫痫患者用药依从性现状和影响因素研究 |
| Study on Current Status and Influencing Factors of Medication Compliance in Children With Epilepsy in China |
| 投稿时间：2017-06-14 |
| DOI：10.16153/j.1002-7777.2017.12.024 |
| 中文关键词: 儿童癫痫 用药依从性 不良反应 合理用药 影响因素 系统评价 |
| 英文关键词: childhood epilepsy medication compliance adverse reactions rational drug use influencing factors systematic evaluation |
| 基金项目:国家自然科学基金—中国儿童合理用药评价指标体系的循证研究（编号：81373381）；四川大学华西第二医院临床科研基金—影响儿童慢性病用药依从性关键因素识别及提高依从性适宜技术构建——以癫痫为例（编号：KL015） |
| 作者 | 单位 | E-mail | | 杨春松 | 四川大学华西第二医院, 成都 610041
四川大学出生缺陷与相关妇儿疾病教育部重点实验室, 成都 610041
四川大学华西第二医院循证药学中心, 成都 610041 | | | 宋虹漪 | 四川大学华西第二医院, 成都 610041
四川大学出生缺陷与相关妇儿疾病教育部重点实验室, 成都 610041
四川大学华西第二医院循证药学中心, 成都 610041
四川大学华西药学院, 成都 610041 | | | 张伶俐 | 四川大学华西第二医院, 成都 610041
四川大学出生缺陷与相关妇儿疾病教育部重点实验室, 成都 610041
四川大学华西第二医院循证药学中心, 成都 610041 | | | 韩璐 | 四川大学华西第二医院, 成都 610041
四川大学出生缺陷与相关妇儿疾病教育部重点实验室, 成都 610041
四川大学华西第二医院循证药学中心, 成都 610041 | 877081400@qq.com |
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| 中文摘要: |
| 目的：评价国内儿童癫痫患者用药依从性的现状和影响因素，为儿童癫痫患者合理用药提供循证医学证据。方法：用计算机检索中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中国科技期刊全文数据库（VIP）、万方数据库，全面收集国内有关儿童癫痫患者用药依从性现状和影响因素类文献。针对依从性现状，采用单组率的Meta分析进行数据合并，针对依从性影响因素采用描述性方法进行汇总分析。结果：共纳入26篇文献，共计患者5580例，样本量为38 ～ 2000（中位数为103）。儿童癫痫患者服药依从率在33%～ 88.1%，meta分析结果显示，依从率为62%，95%可信区间为0.56 ～ 0.68。影响癫痫患儿用药依从性的原因多种多样，包括患者自身因素（如对治疗有信心、对医生信任、担心不良反应等）、药物因素（如疗效、不良反应、服药种类、取药困难、治疗方案复杂等）、家长因素（如对癫痫的认知程度、子女个数）和环境因素（如医生叮嘱等）。病程长短、癫痫类型、患者年龄、家庭经济、家长文化程度和居住地等因素对依从性的影响存在争议。结论：目前我国儿童癫痫患者服药依从性不高，影响依从性的因素较多，且部分因素存在争议。建议开展大样本、长时间随访研究，以便更好地了解我国儿童抗癫痫药物使用依从性现状及相关影响因素，为抗癫痫药物的合理使用提供研究证据。 |
| 英文摘要: |
| Objective: To evaluate the current status and influencing factors of medication compliance in children with epilepsy in China so as to provide evidence-based medical evidence for rational drug use. Methods: Literatures about the current status and influencing factors of medication compliance in children with epilepsy in China were comprehensively collected by searching CBM, CNKI, VIP and Wanfang databases. As far as current status of medication compliance was concerned, data were combined using the method of the meta analysis of prevalence. A descriptive method was used to summarize the influencing factors. Resuults: A total of 26 papers were involved, including 5580 subjects and the sample size was from 38 to 2000 (median was 103). Reported compliance rate ranged from 33% to 88.1%. Meta analysis showed compliance rate was 0.62, 95% CI[0.56-0.68]. There were different kinds of factors influencing the medication compliance in children with epilepsy, such as patients' factors (i.e. confdence in therapy, trust in doctor, worry about adverse reactions, etc.); drug factors (i.e. efficacy, adverse reactions, medication types, difficulty in getting the drugs, and complex treatment program); parental factors (i.e. degree of epilepsy awareness and the number of children) as well as environmental factors (i.e. advice of doctors). The influence of the following factors, such as duration of the disease, types of epilepsy, age of the patients, family economy, education level of parents and residence on medication compliance, was controversial. Conclusion: At present, medication compliance in children with epilepsy is not high. There are many factors influencing the compliance and some factors are controversial. It is suggested that a large sample and a long-term follow-up study should be conducted so as provide a better understanding of the current status and related influencing factors of the compliance of the use of antiepileptic drugs in children in China and offer evidence for the rational use of antiepileptic drugs. |
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