| Background:Tuberculosis(TB) is a serious public health problem. Every year an estimated8.8million new cases of tuberculosis and1.7million TB deaths in the world. China located in low-income country ranks and is one of the22high TB burden countries. In the year of2000,the4th National Tuberculosis Epidemiological surveys show that the number of tuberculosis in China reached6million, ranking second in the world after India, accounting for15%of the total global burden. Tuberculosis is a chronic infectious disease, the treatment course is long and easy to relapse. Currently WTO recommends directly observed treatment shorts course (DOTS) to control TB, and claim that to use standardized rifampicin-based regiments to treat initial nfected patients six months, and relapse patients need eight months of treatment. Due to social, economic and family reasons, full cure is not feasible via hospitalization. So most time of TB treatment regimens is done through the home chemotherapy. TB is highly infectious and resistant to antibiotics, the major factors causing recurrence and mortality are not in accordance with the provisions of the DOTS strategy medication in the process of home treatment. The present study shows that patient factors, drug factors and social factors combined effect home treatment of patients with tuberculosis medication compliance. Because most of our patients were rural residents and have low awareness of TB knowledge, DOTS strategy is not well understood, standard treatment is not well done,resultirtg in overall condition of medication compliance of TB patients is poor.Although TB control institutions have done all efforts at all levels to improve patient compliance and take a variety of methods according to local conditions.However, to improve TB drug compliance is still a very difficult task.Medication compliance involves many aspects,Need to jointly solve patients personal factors, family factors, drug reaction factors, social discrimination factors etc. In this study, according to the actual situation of Shandong Province,Research purposes:Through the analysis of pulmonary tuberculosis patients subjectively reported compliance situation,analysis of influencing factors of medication compliance,finding problems.To solve these problems, propose appropriate measures to improve patient compliance, improve patient cure rate.Materials and Methods:Using Chinese Revision MMAS-8scale and homemade questionnaire,including:sample population demographic characteristics, economic status, health care situation and living conditions, medication compliance sample population situation.The survey used a stratified cluster random sampling method to choose the sample,tuberculosis patients are selected Changqing District, Junan County, Zhangqiu, Wendeng, Rushan County Yishui County and six counties (cities, districts) January1,2011-December201131, registered720cases of patients.Investigate medication compliance of TB patients for home chemotherapy.Collection of information, combined with the expertise of its influencing factors univariate analysis, after which the use of non-conditional Logistic regression model to explore the influencing factors.Main results:TB patient medication compliance situation is generally better,720patients with low medication compliance has214people, accounting for29.7%, medium or high compliance accounted for70.3%.Univariate analysis showed that:The quality of sleep in patients (χ2=8.982, P=0.011),Home health spending accounted for the total annual household income percentage (χ2=9.54, P=0.008),Whether it is poor (χ2=9.385, P=0.009),Whether the government bailout (χ2=7.104, P=0.030), the current life satisfaction overall evaluation(χ2=11.479,P=0.003), as well as on the degree of self-assessment of their disease (χ2=13.264, P=0.001) has different degrees of impact of patients.Logistic regression analysis showed: poor sleep quality, health spending accounted for a high proportion of living expenses, life satisfaction is generally an independent risk factor for patient compliance.Conclusions and suggestions:To strengthen the implementation of the DOTS strategy,improving patient medication compliance,reducing drug-resistant tuberculosis emerge,Government should regulate supervisory management,Free treatment for pulmonary tuberculosis patients treated with whole supervision,According to patients with local health resources distribution and patient preference, determine the reasonable management mode.Mechanism of tuberculosis should provides a free inspection and anti tuberculosis drugs,reducing the economic burden of the patients,strength TB control service system construction,improving the service quality of tuberculosis.Improve the life satisfaction of patients with pulmonary tuberculosis patients, increase the preferential policies, to give some relief on the removal of free drugs other than the check and the transportation and accommodation costs, reduce the economic burden. |
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