| Objectives To investigate the medication adherence of anxiety disorder outpatients which is in mental health center psychiatric consultation clinic,to understand their demographic characteristics,clinical features and so on.According to the five dimensions proposed by WHO,the main influencing factors of medication in patients with anxiety disorder were analyzed and its will helpful to future clinic work.Methods 1.Data were obtained from the outpatient electric information system of Shanghai Mental Health Center and the study started at the first time when the patients took Anxiolytic drugs from 2011 to 2014.Adherence was measured with a medication possession ratio(MPR).2.Subjects were take outpatients in consultation clinic from February 2017 to June,using convenient sampling method taking samples.Around "patient,disease,treatment,socio-economic,health system" do the scale assessment.Using SPSS21.0 statistical software for the data analysis,including descriptive analysis,Mann-Whitney U test and Binary logistic regression.Results In the electronic database analysis,a total of 12,694 newly diagnosed outpatients were in and their average annual MPR value were 0.42±0.69.In the current situation survey,a total of 180 outpatients were investigated and 178(98.9%)effective CRF have been got.Details as follows:1.Descriptive statistical analysis: The median age of the subjects was 37(17,95)years,43.3% were male,56.7% were female;87.6% were general anxiety disorder,9.0% were panic disorder,and 3.4% were social phobia.Among them,48.9% of patients with MARS ≥ 7 points,51.1% of patients with MARS <7 points.2.Single factor differential test:(1)There was a significant difference between the two groups of patients’ age and household monthly income(P<0.01).(2)Relapse of patients with good compliance were significantly less than those with poor compliance(P<0.01);comorbidity,social function impairment in patients with compliance was significantly worse than the remaining patients(P<0.01);patients which used have treatment in psychological counseling agencies or Chinese medicine hospital were less compliance than the rest of the patients(P<0.01).(3)Patients with discontinuation history were significantly worse in adherence than those without a history of withdrawal(P<0.01);patients with prescription SSRIs had significantly better medication compliance than the rest of the patients(P<0.01).(4)Patients with good compliance had significantly lower HAMA and GI scores than those with poor compliance(P<0.01).(5)There were significant differences in scores between LES,GSES,BMQ-S and SF-36 in both groups(P<0.01);In EPQ,patients with good compliance had higher E scores than those with poor compliance,while N points were significantly lower in patients with poor compliance(P<0.01).(6)There was no significant difference in PDRQ-13 between the two groups(P>0.05),But from the doctor’s point of view,the patients which doctor felt "difficult" with compliance significantly worse than the rest of the patients(P<0.01).(7)Family care index and social support in compliance were significantly better than those with poor compliance(P<0.01).3.Binary logistic regression: Medication beliefs and self-efficacy into the equation,and statistically significant(P<0.01),the OR values were 0.33(0.16,0.69),0.54(0.31,0.92).Conclusions The medication adherence of anxiety disorder outpatients which is in mental health center psychiatric consultation clinic was significantly poor.Among them,"medication belief" and "self-efficacy" is the main factor affecting medication adherence. |
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