Study On The Compliance And Related Factors Of Treatment In Patients With Depression

Objective:We explore the relationship and impact of different factors on treatment compliance of depression patients so as to improve the treatment compliance of depression patients and the curative rate.Methods:From the outpatient and inpatient of our hospital during the period of March 2016 to August 2017,we selected 120 ones as the research objects.All diagnoses were determined by the attending physician at least.The diagnosis of the disease complied with the criteria for depression in the icd-10 classification of mental and behavioral disorders.The ages of all selected patients were over 18,gender was not limited.The onset of depression caused by organic mental disorders,active substances,pregnancy and breastfeeding were all eliminated,so were the patients not welling to participate in the investigation.Follow-up investigation was performed on selected depression patients who met the criteria mentioned above,and more than ten impacting factors including drug side effects,degree of recognition to the diagnosis,severity of disease,medication experience,doctor-patient communication,characteristics of medical care,understanding of diseases and drugs,gentle,education level,etc.were determined after the literature analysis.Depression treatment compliance questionnaire,Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),and social support rating scale(SSRS)were used as assessment tools to further analyze the corresponding weight of single factor mode and its Logistic regression analysis of variance,and to discuss correlation between the ten factors and treatment compliance.The causation of breakoff was investigated and analyzed after medication of different time range(within one month,one to three months,three to six months,six to nine months,and more than nine months).And taking the results as the basis,we exerted corresponding intervention measures and strategies on the patients.Results:According to the statistics results,the average score of Hamilton depression scale was22±4.6 in the 120 selected patients.From the view of individual comparison,there was no condition deterioration,and there was a trend of decrease of scores with different degrees.But overall,the score still follow the distribution standard of depression diagnosis.Among all patients,there were 29 cases with a total score of less than 8,and the curative rate was 24.17%.The amount of patients with score between 8 and 20 was 37 accounting for 30.83%.54patients(45%)had the score of 20 to 35.None case had a score higher than 35.The average treatment compliance of the remaining 91 cases was-42.96 + 17.31 d.In order to further understand the relationship between the compliance and the impacting factors,we carried out the weight analysis based on the questionnaire results.It demonstrated that drug side effects(0.21),the features of medical care(0.19),the patients' recognition process to drugs(0.13)become the main factors that influence the compliance which collectively explained 53%causes of the formation of incompliance.From the result of the weight analysis mentioned above,we can see that there is a certain dependency relationship under some impacting factors,that is,different impacting factors have inner influence distribution and effect each other mutually.We also analyzed the reasons of breakoff in different time ranges.According to the results,the highest rate of breakoff was in first month of treatment,the main reason of which was that patients did not accept the diagnosis results and worried about the drug side effects.The main reason for breakoff in one to three months was that the patients felt better and thought that the drug was not effective.In the times of three to six months,six to nine months,and longer than nine months,the reasons for breakoff were roughly the same,including drug withdrawal due to that patients felt better,financial difficulty,etc.Conclusion:Medication compliance of depression patient is influenced by many factors.Ten factors including patients' recognition of diagnosis,severity of disease,the patient's medication experience,doctor-patient communication,the features of medical care,patients' understanding of depression and drugs,age,gender,and education level could impact on medication compliance.It is suggested that medical staffs should additionally provide return visit and communication in the course of treatment to improve the compliance of treatment.The highest rate of breakoff is in the early and middle phase of treatment,especially within one month.So intervention should be given to the patients treated for one month.Side effects and working time of drugs need to be thoroughly explained in the early phase of medication.