Research On The Treatment Compliance Scoring System For Patients With Pulmonary Tuberculosis In Guizhou

BackgroundPulmonary tuberculosis is one of the prevailing communicable diseases all over the world.In terms of the high burdens of pulmonary tuberculosis,China ranked the second among 22 countries.The incidence rate of pulmonary tuberculosis in Guizhou was highest all over the country.The major prevention measures on the pulmonary tuberculosis are to find and cure the patients of which the patient's compliance is of great importance.ObjectiveTo analyze the current situation and influence factors of pulmonary tuberculosis patient's compliance in Guizhou,evaluate the clinical effect of ARS and explore the prevention measures on the improvement of the patient's compliance.According to the research results,it was possible to optimize the limited resources in the prevention of pulmonary tuberculosis,save the controlling cost of social diseases and improve the total compliance in Guizhou.MethodIn 88 counties of Guizhou province,10 counties were randomly selected.Within 6m,the patients with active tuberculosis were selected.The pulmonary tuberculosis patient's treatment compliance was analyzed;ARS was used to evaluate the patient's compliance;RCT(randomized controlled trial)was used to evaluate the prevention measures.Result1.1749 patients with pulmonary tuberculosis were selected.During the process of re-checking and taking medicine,there were 1001 non-compliance cases for at least one time(57.2%);the non-compliance for twice was 17.2%;the non-compliance for three times was 5.1%.For 1001 caes,the patients of delaying the treatment for 2-9 days accounted for about 50%;the patients of dealying the treatment for over 30 days accounted for 19.8%.The diagnosis results,initial treatment and re-treatment conditions as well as the total compliance rate were significantly different(P<0.05).The influence factors of the total compliance were diagnosis results and the initial treatment and re-treatment conditions(P<0.05).2.The evaluation results based on ARS were basically consistent with the actual compliance results(Kappa coefficient=0.403,P<0.001);the sensitivity,specificity and Youden's index was 71.1%,70.2% and 0.41.The major influence factors of actual compliance was ARS scores and the initial treatment and re-treatment conditions(P<0.05).According to the multivariate analysis,OR of ARS was equal to 5.649.Based on ARS score,the compliance cases were 5.649 times more than non-compliance cases.3.In the end of May and June(August),the compliance of intervention group was significantly higher than that of control group;the average delay days for intervention group were significantly lower than that of control group;according to the multivariate analysis,the key influence factor of the patient's compliance was the intervention measures.Conclusion1.In Guizhou,there were just a few of patients of taking the standard treatment.There were a few of patients of delaying the treatment;the total compliance for positive cases was higher than that of negative cases.The total compliance for patients of taking the initial treatment was higher than that of patients of taking the re-examination.2.ARS can accurately evaluate the patient's compliance,but it still needs to be improved.3.The efficient intervention measures like proper health education and the county's supervision are good to improve the patient's compliance.