中文版MMAS-8评价心血管慢病患者用药依从性的信效度分析与实践
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摘要
目的:分析中文版8条目Morisky用药依从性量表(MMAS-8)评价心血管慢病患者用药依从性的信效度,并用其评价药物重整对患者用药依从性的影响。方法:选取97例心血管慢病患者为观察组,进行中文版MMAS-8信效度评价并予以药物重整;选取91例心血管慢病患者为对照组,仅予以常规医疗服务。采用该量表评价两组患者不同时段的用药依从性。结果:问卷得分排序前后27%的两个极端组的8条目平均分的F检验差异、t检验差异均有统计学意义(P<0.001);8条目与总分的相关系数均大于0.400,且与总分均显著相关(P<0.001);内部一致性系数为0.763;结构效度KMO值为0.742,Bartlett’s球形检验值为266.007,共提取2个公共因子,共解释总方差的58.907%。与对照组比较,观察组患者出院1周和出院1个月时用药依从性明显提高(P<0.05)。结论:中文版MMAS-8评价心血管慢病患者用药依从性的信效度较好;药物重整可提高用药依从性。
OBJECTIVE:To analyze the reliability and validity of Chinese version of MMAS-8 in evaluating the medication compliance of patients with chronic cardiovascular diseases,and to evaluate the effects of medication reconciliation on medication compliance. METHODS:Totally 97 patients with chronic cardiovascular diseases were selected as observation group. The reliability and validity of the questionnaire were analyzed and medication reconciliation was carried out. Totally 91 patients with chronic cardiovascular diseases were selected as control group,and given routine medical services. 8-item Morisk Medication Compliance Scale used to evaluate the drug compliance of the two groups at different time points. RESULTS:The F-test and t-test of the average score of 8 items in 27% of questionnaire score ranking head and tail of the two extreme groups had statistical significance(P<0.001). Correlation coefficient between the 8 items and the total scores was higher than 0.400,and the 8 items were significantly correlated with total scores(P<0.001). Internal consistency reliability coefficient was 0.763;the structure validity KMO value was 0.742;the Bartlett's spherical test value was 266.007;factor analysis method was adopted to extract 2 common factors,and explained total variance was 58.907%. Compared with control group,medication compliance of observation group was improved significantly at the first week after discharge and one month after discharge(P<0.05). CONCLUSIONS:The Chinese version of MMAS-8 has good reliability and validity in evaluating drug compliance of patients with chronic cardiovascular disease;medication reconstitution service can improve medication compliance of patients.
OBJECTIVE:To analyze the reliability and validity of Chinese version of MMAS-8 in evaluating the medication compliance of patients with chronic cardiovascular diseases,and to evaluate the effects of medication reconciliation on medication compliance. METHODS:Totally 97 patients with chronic cardiovascular diseases were selected as observation group. The reliability and validity of the questionnaire were analyzed and medication reconciliation was carried out. Totally 91 patients with chronic cardiovascular diseases were selected as control group,and given routine medical services. 8-item Morisk Medication Compliance Scale used to evaluate the drug compliance of the two groups at different time points. RESULTS:The F-test and t-test of the average score of 8 items in 27% of questionnaire score ranking head and tail of the two extreme groups had statistical significance(P<0.001). Correlation coefficient between the 8 items and the total scores was higher than 0.400,and the 8 items were significantly correlated with total scores(P<0.001). Internal consistency reliability coefficient was 0.763;the structure validity KMO value was 0.742;the Bartlett's spherical test value was 266.007;factor analysis method was adopted to extract 2 common factors,and explained total variance was 58.907%. Compared with control group,medication compliance of observation group was improved significantly at the first week after discharge and one month after discharge(P<0.05). CONCLUSIONS:The Chinese version of MMAS-8 has good reliability and validity in evaluating drug compliance of patients with chronic cardiovascular disease;medication reconstitution service can improve medication compliance of patients.
引文
[1]国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告:2015[R].北京:人民卫生出版社,2015:33-50.
[2] MORISKY DE,ANG A,KROUSEL-WOOD M,et al.Predictive validity of a medication adherence measure in an outpatient setting[J]. J Clin Hypertens,2008,10(5):348-354.
[3]朱孔彩,张亚同,曹国颖.临床药师在药物整合服务中的实践总结[J].中国药房,2013,34(46):4412-4414.
[4]施楠楠,甄健存,谢颖,等.临床药师慢病管理工作模式的探讨[J].临床药物治疗杂志,2015,13(1):83-86.
[5]路敏,崔一民,白文佩.慢病管理的药学服务模式探讨[J].中国新药杂志,2014,23(2):244-246.
[6]刘治军.国外临床药师药物重整工作简介[J].药品评价,2012,9(32):6-9.
[7]罗伯特·F·德威利斯.量表编制:理论与应用[M].魏勇刚,龙长权,宋武,译.2版.重庆:重庆大学出版社,2004:104-106.
[8] YAN J,YOU LM,YANG Q,et al. Translation and validation of a Chinese version of the 8-item morisky medication adherence scale in myocardial infarction patients[J]. J Eval Clin Pract,2014,20(4):311-317.
[9]王洁,莫永珍,卞茸文.中文版8条目Morisky用药依从性问卷在2型糖尿病患者中应用的信效度评价[J].中国糖尿病杂志,2013,21(12):1101-1104.
[10]付晓丽,牛卫理,杨淑敏,等. Morisky问卷测量AIDS患者服药依从性的信度和效度[J].郑州大学学报(医学版),2016,51(3):421-423.
[11]吴凡,赵金霞,王天晟,等.中文版MMSA-8测量类风湿关节炎患者用药依从性的信效度分析[J].中国药房,2018,29(2):263-268.
[12]寸金芝,赵丽琴. Morisky问卷评价精神分裂症恢复期患者服药依从性的信度和效度[J].临床精神医学杂志,2016,26(3):185-186.
[13]朱桂华,王永志,童宗武,等.中文版风湿病治疗依从性问卷的信度和效度研究[J].中国全科医学,2013,16(30):2803-2805.
[14]赵欣.慢病管理的现状与发展方向[J].中国临床医生,2012,40(3):42-44.
[15] GLEASON KM,MCDANIEL MR,FEINGLASS J,et al.Results of the medications at transitions and clinical handoffs(MATCH)study:an analysis of medication reconciliation errors and risk factors at hospital admission[J]. J Gen Inter Med,2010,25(5):441-447.
[16] MAGID DJ,HO PM,OLSON KL,et al. A multimodal blood pressure control intervention in 3 healthcare systems[J]. Am J Manag Care,2011,17(4):e96-e103.
[2] MORISKY DE,ANG A,KROUSEL-WOOD M,et al.Predictive validity of a medication adherence measure in an outpatient setting[J]. J Clin Hypertens,2008,10(5):348-354.
[3]朱孔彩,张亚同,曹国颖.临床药师在药物整合服务中的实践总结[J].中国药房,2013,34(46):4412-4414.
[4]施楠楠,甄健存,谢颖,等.临床药师慢病管理工作模式的探讨[J].临床药物治疗杂志,2015,13(1):83-86.
[5]路敏,崔一民,白文佩.慢病管理的药学服务模式探讨[J].中国新药杂志,2014,23(2):244-246.
[6]刘治军.国外临床药师药物重整工作简介[J].药品评价,2012,9(32):6-9.
[7]罗伯特·F·德威利斯.量表编制:理论与应用[M].魏勇刚,龙长权,宋武,译.2版.重庆:重庆大学出版社,2004:104-106.
[8] YAN J,YOU LM,YANG Q,et al. Translation and validation of a Chinese version of the 8-item morisky medication adherence scale in myocardial infarction patients[J]. J Eval Clin Pract,2014,20(4):311-317.
[9]王洁,莫永珍,卞茸文.中文版8条目Morisky用药依从性问卷在2型糖尿病患者中应用的信效度评价[J].中国糖尿病杂志,2013,21(12):1101-1104.
[10]付晓丽,牛卫理,杨淑敏,等. Morisky问卷测量AIDS患者服药依从性的信度和效度[J].郑州大学学报(医学版),2016,51(3):421-423.
[11]吴凡,赵金霞,王天晟,等.中文版MMSA-8测量类风湿关节炎患者用药依从性的信效度分析[J].中国药房,2018,29(2):263-268.
[12]寸金芝,赵丽琴. Morisky问卷评价精神分裂症恢复期患者服药依从性的信度和效度[J].临床精神医学杂志,2016,26(3):185-186.
[13]朱桂华,王永志,童宗武,等.中文版风湿病治疗依从性问卷的信度和效度研究[J].中国全科医学,2013,16(30):2803-2805.
[14]赵欣.慢病管理的现状与发展方向[J].中国临床医生,2012,40(3):42-44.
[15] GLEASON KM,MCDANIEL MR,FEINGLASS J,et al.Results of the medications at transitions and clinical handoffs(MATCH)study:an analysis of medication reconciliation errors and risk factors at hospital admission[J]. J Gen Inter Med,2010,25(5):441-447.
[16] MAGID DJ,HO PM,OLSON KL,et al. A multimodal blood pressure control intervention in 3 healthcare systems[J]. Am J Manag Care,2011,17(4):e96-e103.