中国15个城市儿童服药困难问题的初步调查分析
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摘要
目的 了解中国儿童服药困难的现患率,为制定改善儿童服药困难的具体措施提供参考依据。方法 采用整群随机抽样方法,2017年6-12月在全国13个省自治区直辖市15个城市51所医院随机抽取门诊及住院的23 492名儿童为研究对象,采用儿童服药困难筛选调查问卷对受试儿童家长进行现场调查。结果 中国儿童服药困难发生率为75.44%(17 723/23 492),其中轻度服药困难占35.62%(8 369/23 492),中度占26.81%(6 299/23 492),重度占9.25%(2 173/23 492),严重占3.75%(882/23 492)。3岁以下年龄段服药困难的发生率最高,达81.42%(7 027/8 631);其次是3～6岁,占75.37%(7 792/10 339)。结论 中国儿童服药困难的发生率较高,尤其3～6岁年龄段的儿童,需广泛关注。
Objective To investigate the prevalence of Chinese children′s difficulties of taking medicine,in order to provide reference for formulating specific measures to improve the difficulties of taking medicine for children. Method A cluster random sampling method was used to collect 23 492 children in 51 hospitals in 15 autonomous regions and municipalities of 13 provinces from June to December in 2017,and self-designed children′s drug difficulty screening questionnaires were adopted to investigate the parents of the children in the field. Results The prevalence rate of Chinese children′s difficulty in taking medicine was 75.44%(17 723/23 492).Among them,the mild,moderate,severe and very severe difficulty of taking drug accounted for 35.62%(8 369/23 492),26.81%(6 299/23 492),9.25%(2 173/23 492) and 3.75%(882/23 492),respectively.Children under 3 years old experienced difficulty in taking medicine most [81.42%(7 027/8 631)],followed by children aged 3 to 6 years [75.37%(7 792/10 339)]. Conclusion Difficulty in taking medicine for Chinese children is prevalent,especially for children aged 3 to 6 years,which needs wide attention.
Objective To investigate the prevalence of Chinese children′s difficulties of taking medicine,in order to provide reference for formulating specific measures to improve the difficulties of taking medicine for children. Method A cluster random sampling method was used to collect 23 492 children in 51 hospitals in 15 autonomous regions and municipalities of 13 provinces from June to December in 2017,and self-designed children′s drug difficulty screening questionnaires were adopted to investigate the parents of the children in the field. Results The prevalence rate of Chinese children′s difficulty in taking medicine was 75.44%(17 723/23 492).Among them,the mild,moderate,severe and very severe difficulty of taking drug accounted for 35.62%(8 369/23 492),26.81%(6 299/23 492),9.25%(2 173/23 492) and 3.75%(882/23 492),respectively.Children under 3 years old experienced difficulty in taking medicine most [81.42%(7 027/8 631)],followed by children aged 3 to 6 years [75.37%(7 792/10 339)]. Conclusion Difficulty in taking medicine for Chinese children is prevalent,especially for children aged 3 to 6 years,which needs wide attention.
引文
[1] 王丽.规范儿童用药,保障儿童健康[J].儿科药学杂志,2016,22(3):1-4.
[2] Shirkey H.Therapeutic orphans[J].Pediatrics,1999,104(3):583.
[3] De Geest S,Sabaté E.Adherence to long-term therapies:evidence for action[J].Eur J Cardiovasc Nurs,2003,2(4):323.
[4] Dalic L,Cook MJ.Managing drug-resistant epilepsy:challenges and solutions[J].Neuropsychiatr Dis Treat,2016,12(8):2605-2616.
[5] 闵晓青,田侃,喻小勇,等.美国儿童用药立法保障评析及对我国的启示[J].中国药房,2017,28(13):1740-1743.
[6] 刘恩梅,陆权.规范儿童用药,保障儿童健康[J].儿科药学杂志,2016,22(3):1005-1007.
[7] Liorca PM.Discussion of prevalence and management of discomfort when swallowing pills:orodispersibletablets expand treatment options in patients with depression[J].Ther Deliv,2011,2(5):611-622.
[8] Schiele JT,Quinzler R,Klimm HD,et al.Difficulties swallowing solid oral dosage forms in a general practice population:prevalence,causes,and relationship to dosage forms[J].Eur J Clin Pharmacol,2013,69(4):937-948.
[9] Lam WY,Fresco P.Medication adherence measures:an overview[J].Biomed Res Int,2015,2015(10):217047.
[10] 寸冬梅,李炜,孙琳,等.儿科药物制剂设计及新剂型开发[J].中国药学杂志,2012,47(10):760-765.
[11] Mennella JA,Beauchamp GK.Optimizing oral medications for children[J].Clin Ther,2008,30(11):2120-2132.
[12] Hall CP.How you can simplify your patient′s medication regimen to enhance adherence[J].Current Psychiatry,2017,16(5):18-21,29.
[13] Morita T.Development of deglutition aid jelly for oral administration[J].Ykugaku Zasshi,2003,123(8):665-671.
[14] Coviello T,Trotta AM,Marianecci C,et al.Gel-embedded niosomes:preparation,characterization and release studies of a new system for topical drug delivery[J].Colloids Surf B Biointerfaces,2015,125(1):291-299.
[15] Walsh KE,Mazor KM,Stille CJ,et al.Can a flavored spray (pill glide) help children swallow their medicines?a pilot study[J].Arch Dis Child,2011,96(6):581-586.
[2] Shirkey H.Therapeutic orphans[J].Pediatrics,1999,104(3):583.
[3] De Geest S,Sabaté E.Adherence to long-term therapies:evidence for action[J].Eur J Cardiovasc Nurs,2003,2(4):323.
[4] Dalic L,Cook MJ.Managing drug-resistant epilepsy:challenges and solutions[J].Neuropsychiatr Dis Treat,2016,12(8):2605-2616.
[5] 闵晓青,田侃,喻小勇,等.美国儿童用药立法保障评析及对我国的启示[J].中国药房,2017,28(13):1740-1743.
[6] 刘恩梅,陆权.规范儿童用药,保障儿童健康[J].儿科药学杂志,2016,22(3):1005-1007.
[7] Liorca PM.Discussion of prevalence and management of discomfort when swallowing pills:orodispersibletablets expand treatment options in patients with depression[J].Ther Deliv,2011,2(5):611-622.
[8] Schiele JT,Quinzler R,Klimm HD,et al.Difficulties swallowing solid oral dosage forms in a general practice population:prevalence,causes,and relationship to dosage forms[J].Eur J Clin Pharmacol,2013,69(4):937-948.
[9] Lam WY,Fresco P.Medication adherence measures:an overview[J].Biomed Res Int,2015,2015(10):217047.
[10] 寸冬梅,李炜,孙琳,等.儿科药物制剂设计及新剂型开发[J].中国药学杂志,2012,47(10):760-765.
[11] Mennella JA,Beauchamp GK.Optimizing oral medications for children[J].Clin Ther,2008,30(11):2120-2132.
[12] Hall CP.How you can simplify your patient′s medication regimen to enhance adherence[J].Current Psychiatry,2017,16(5):18-21,29.
[13] Morita T.Development of deglutition aid jelly for oral administration[J].Ykugaku Zasshi,2003,123(8):665-671.
[14] Coviello T,Trotta AM,Marianecci C,et al.Gel-embedded niosomes:preparation,characterization and release studies of a new system for topical drug delivery[J].Colloids Surf B Biointerfaces,2015,125(1):291-299.
[15] Walsh KE,Mazor KM,Stille CJ,et al.Can a flavored spray (pill glide) help children swallow their medicines?a pilot study[J].Arch Dis Child,2011,96(6):581-586.