肺结核患者对结核助手APP和电子药盒的使用意愿和效果分析

doi:10.19983/j.issn.2096-8493.20210110

摘要/Abstract

摘要：

目的: 分析肺结核患者对结核助手APP和电子药盒的使用意愿和使用效果。 方法: 收集2019年5月1日至10月31日上海市松江区登记的297例活动性肺结核患者,按照登记顺序及入选标准进行筛选,在知情同意的原则下,符合纳入条件的269例患者自主选择是否使用结核助手APP或电子药盒,最终72例患者纳入结核助手APP组,76例患者纳入电子药盒组,对两组进行前瞻性督导服药管理研究直到疗程结束。对不同性别、年龄、户籍患者选择使用结核助手APP、电子药盒的意愿以及结核助手APP组和电子药盒组总体服药率进行分析。结果: 269例患者中,选择使用结核助手APP的有72例,使用率为26.8%。本市户籍患者使用率为13.6%(11/81),流动人口患者使用率为32.4%(61/188),差异有统计学意义(χ²=10.28,P<0.01)。18~44岁年龄组使用率为35.4%(67/189),45~59岁年龄组使用率为8.8%(3/34),≥60岁年龄组使用率为4.3%(2/46),差异有统计学意义(χ²=24.65,P<0.01)。269例患者中,选择使用电子药盒有76例,使用率为28.3%。本市户籍患者使用率为51.9%(42/81),流动人口患者使用率为18.1%(34/188),差异有统计学意义(χ²=31.84,P<0.01)。18~44岁年龄组使用率为19.6%(37/189),45~59岁年龄组使用率为38.2%(13/34),≥60岁年龄组使用率为56.5%(26/46),差异有统计学意义(χ²=26.83,P<0.01)。197例患者不愿意使用结核助手APP,主要原因为患者认为每天打卡很麻烦,占44.7%(88/197)。193例患者不愿意使用电子药盒,主要原因为患者认为使用药盒不如直接服药方便,占29.0%(56/193)。结核助手APP组总体服药率为95.2%(19478/20461),高于电子药盒组[93.3%(20183/21631)],差异有统计学意义(χ²=69.01,P<0.01)。结核助手APP组总体规则服药率为93.1%(67/72),电子药盒组总体规则服药率为90.8%(69/76)。结论: 肺结核患者对于结核助手APP和电子药盒有一定的使用意愿,运用结核助手APP和电子药盒对肺结核患者进行督导服药管理对患者的服药率和治疗依从性有较好效果。

关键词: 结核,肺, 病人医护管理, 计算机通信网络, 药物治疗依从性

Abstract:

Objective: To analyze the willingness and effect of tuberculosis assistant APP and electronic kit in pulmonary tuberculosis patients. Methods: A total of 297 active pulmonary tuberculosis patients registered in Songjiang District, Shanghai from May 1 to October 31, 2019 were collected and screened according to the registration order and inclusion criteria. Based on the principle of informed consent, 269 patients who met the inclusion criteria were selected. After independent choose of tuberculosis assistant APP or electronic kit voluntarily, the cases were divided into tuberculosis assistant APP group (n=72) and electronic kit group (n=76). These 148 patients were prospectively studied until the end of the course of treatment. The willingness of patients with different gender, age and household registration to choose the tuberculosis assistant APP or the electronic kit, and the overall medication rate of the tuberculosis assistant APP group and the electronic kit group were analyzed. Results: Among the 269 patients, 72 chose the tuberculosis assistant APP, with a usage rate of 26.8%. The usage rate of household registration patients in this city was 13.6% (11/81), and the usage rate of floating population patients was 32.4% (61/188), and the difference was statistically significant (χ²=10.28, P<0.01). The usage rate of patients aged 18-44 years was 35.4% (67/189), the usage rate of patients aged 45-59 years was 8.8% (3/34), and the usage rate of patients aged ≥60 years was 4.3% (2/46), the difference was statistically significant (χ²=24.65, P<0.01). Of the 269 patients, 76 chose the electronic kit, with a usage rate of 28.3%. The usage rate of household registration patients in this city was 51.9% (42/81), and the usage rate of floating population patients was 18.1% (34/188), the difference was statistically significant (χ²=31.84, P<0.01). The selection rate of patients aged 18-44 years was 19.6% (37/189), the usage rate of patients aged 45-59 years was 38.2% (13/34), and the usage rate of patients aged ≥60 years was 56.5% (26/46), the difference was statistically significant (χ²=26.83, P<0.01). There were 197 patients unwilling to use the tuberculosis assistant APP, mainly because they thought it was troublesome to punch in every day, which accounting for 44.7% (88/197); 193 patients were unwilling to use electronic kit, the main reason was that they thought using pill boxes was not as convenient as taking medicine directly, which accounting for 29.0% (56/193). The overall medication rate of the tuberculosis assistant APP group was 95.2% (19478/20461), which was significantly higher than that of the electronic kit group (93.3%, 20183/21631) (χ²=69.01, P<0.01). The overall regular medication rate of tuberculosis assistant APP group was 93.1% (67/72), and that of electronic kit group was 90.8% (69/76). Conclusion: Pulmonary tuberculosis patients have a certain willingness to use the tuberculosis assistant APP and the electronic kit. The use of the tuberculosis assistant APP and the electronic kit to supervise the medication management of pulmonary tuberculosis patients has a good effect on the medication rate and treatment compliance.

Key words: Tuberculosis,pulmonary, Patient care management, Computer communication networks, Medication adherence

中图分类号:

李勇, 路丽苹, 李瑾, 邹金燕. 肺结核患者对结核助手APP和电子药盒的使用意愿和效果分析[J]. 结核与肺部疾病杂志, 2022, 3(1): 22-26. doi: 10.19983/j.issn.2096-8493.20210110

LI Yong, LU Li-ping, LI Jin, ZOU Jin-yan. Analysis of willingness and effect of tuberculosis assistant APP and electronic kit in pulmonary tuberculosis patients[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(1): 22-26. doi: 10.19983/j.issn.2096-8493.20210110

图/表 2

参考文献 15

[1]	World Health Organization. Guidelines for treatment of drug-susceptible tuberculosis and patient care. Geneva: World Health Organization, 2017.
[2]	李雪, 姜世闻, 胡冬梅, 等. 电子药盒和手机微信APP的应用对肺结核患者服药依从性的效果评价. 中国防痨杂志, 2019, 41(9):957-961. doi: 10.3969/j.issn.1000-6621.2019.09.009. doi: 10.3969/j.issn.1000-6621.2019.09.009
[3]	World Health Organization. Handbook for the use of digital technologies to support tuberculosis medication adherence. Geneva:World Health Organization, 2017.
[4]	马艳, 杜建, 刘宇红, 等. 移动医疗在结核病患者管理中的作用. 中国防痨杂志, 2016, 38(7):527-530. doi: 10.3969/j.issn.1000-6621.2016.07.003. doi: 10.3969/j.issn.1000-6621.2016.07.003
[5]	Subbaraman R, de Mondesert L, Musiimenta A, et al. Digital adherence technologies for the management of tuberculosis therapy:mapping the landscape and research priorities. BMJ Glob Health, 2018, 3(5):e001018. doi: 10.1136/bmjgh-2018-001018. doi: 10.1136/bmjgh-2018-001018 URL
[6]	杜建, 刘宇红, 马淑玉, 等. 以移动互联网技术加强结核病患者督导管理. 结核病与肺部健康杂志, 2016, 5(1):23-26. doi: 10.3969/j.issn.2095-3755.2016.01.008. doi: 10.3969/j.issn.2095-3755.2016.01.008
[7]	王倪, 黄飞, 张慧. 电子药盒在结核病患者服药管理中的应用与进展. 结核病与肺部健康杂志, 2019, 8(4):244-248. doi: 10.3969/j.issn.2095-3755.2019.04.003. doi: 10.3969/j.issn.2095-3755.2019.04.003
[8]	王嘉雯, 黄珊珊, 刘恺懿, 等. 对结核病患者实施移动通信直接面视下短程督导化疗的效果评价. 中国防痨杂志, 2019, 41(9):946-950. doi: 10.3969/j.issn.1000-6621.2019.09.007. doi: 10.3969/j.issn.1000-6621.2019.09.007
[9]	李源, 高风华, 金锋. DOTS联合微信管理方式对肺结核患者治疗管理效果的评价. 结核与肺部疾病杂志, 2021, 2(1):50-53. doi: 10.3969/j.issn.2096-8493.2021.01.011. doi: 10.3969/j.issn.2096-8493.2021.01.011
[10]	房宏霞. 从互联网到大数据——结核病患者管理面临的机遇与挑战. 中国防痨杂志, 2017, 39(7):677-678. doi: 10.3969/j.issn.1000-6621.2017.07.002. doi: 10.3969/j.issn.1000-6621.2017.07.002
[11]	秦玉宝, 谢艳光, 房宏霞, 等. 语音短信督导系统在城区涂阳肺结核患者治疗管理中的应用. 中国防痨杂志, 2017, 39(7):695-701. doi: 10.3969/j.issn.1000-6621.2017.07.006. doi: 10.3969/j.issn.1000-6621.2017.07.006
[12]	张婷, 席明霞, 谢和宾, 等. 微信督导对初治肺结核患者服药依从性的影响. 中国继续医学教育, 2017, 9(5):209-211.doi: 10.3969/j.issn.1674-9308.2017.05.116. doi: 10.3969/j.issn.1674-9308.2017.05.116
[13]	郝晓刚, 王炜, 张幸, 等. 应用电子药盒辅助肺结核患者服药管理的实施情况研究. 中国防痨杂志, 2022, 44(1):110-112. doi: 10.19982/j.issn.1000-6621.20210339. doi: 10.19982/j.issn.1000-6621.20210339
[14]	赵茜, 罗珑, 王瑞, 等. 微信应用于肺结核患者健康管理服务的可行性研究. 现代预防医学, 2021, 48(3):559-576.
[15]	景睿, 曹艳民, 杨一军, 等. 电子药盒和手机微信APP对肺结核患者督导服药管理的应用研究. 结核与肺部疾病杂志, 2020, 1(1):96-99. doi: 10.3969/j.issn.2096-8493.2020.01.020. doi: 10.3969/j.issn.2096-8493.2020.01.020

原因	例数	构成比(%)
使用药盒不如直接服药方便	56	29.0
使用药盒暴露隐私	40	20.7
药盒空间不足	21	10.9
平时忙没有时间精力	20	10.4
药盒设计不合理	19	9.8
拒绝参加本研究	16	8.3
药盒需要充电	15	7.8
其他(回乡、不配合管理等)	6	3.1