基于安德森模型的老年肺癌共病患者潜在不适当用药行为的影响因素研究

Research on the Influencing Factors of Potential Inappropriate Drug Use Behavior in Elderly Lung Cancer Comorbidity Patients Based on Anderson’s Model

摘要: 目的：基于安德森模型对老年肺癌共病患者潜在不适当用药行为(PIM)的现状进行研究，并分析其影响因素。方法：采用便利抽样法，选取2024年3月~2024年6月174例在乌鲁木齐市某三甲肿瘤专科医院就诊的老年肺癌患者作为调查对象，采用一般情况量表、莫里斯基药物依从性量表(MMAS-8)、合理用药自我效能量表(SEAMS)、服药信念量表(BMQ)、Charlson合并症指数量表(CCI)和中国老年人潜在不适当用药判断标准(2017版)进行问卷调查，并运用SPSS 25.0软件分析数据。结果：本研究共发放调查问卷185份，回收有效问卷174份(94.05%)。肺癌共病患者服药依从性中高依从性占12.6%，中依从性占26.4%，低依从性占61.0%。职业类型、文化程度、家庭人均月收入对肺癌共病老年患者的服药依从性差异有统计学意义(P < 0.05)，服药信念与服药依从性有显著影响(r = 0.551^**)，多因素回归分析显示，影响肺癌共病患者服药依从性的主要因素为文化程度、职业类型、家庭人均月收入。结论：肺癌共病患者口服药物依从性较低。医护人员应鼓励家属给予患者更多的关注和支持，增进患者间的支持，并进一步发展延续性护理，发挥自身专业优势，针对性地开展健康教育提升患者合理用药自我效能和服药信念，从而提高患者服药依从性，减少PIM发生，改善患者治疗效果和生活质量，帮助患者提高药物素养，从而提高患者服药依从性，促进患者的康复。

Abstract: Objective: To study the current status of potential inappropriate medication behavior (PIM) in elderly patients with lung cancer comorbidity based on the Anderson model, and to analyze its influencing factors. Methods: Using a convenience sampling method, 174 elderly lung cancer patients treated at a tertiary cancer hospital in Urumqi from March 2024 to June 2024 were selected as survey subjects. The study employed the General Information Questionnaire, Morisky Medication Adherence Scale (MMAS-8), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), Beliefs about Medicines Questionnaire (BMQ), Charlson Comorbidity Index (CCI), and the Chinese Criteria for Potentially Inappropriate Medication Use in Older Adults (2017 edition) for data collection. Data were analyzed using SPSS 25.0 software. Results: A total of 185 questionnaires were distributed, with 174 valid responses collected (94.05%). Among elderly lung cancer patients with comorbidities, medication adherence levels were distributed as follows: high adherence (12.6%), moderate adherence (26.4%), and low adherence (61.0%). Occupational type, education level, and monthly household per capita income showed statistically significant differences in medication adherence (P < 0.05). Medication beliefs had a significant impact on adherence (r = 0.551^**). Multivariate regression analysis revealed that the main factors influencing medication adherence in these patients were education level, occupational type, and monthly household per capita income. Conclusion: Patients with comorbid lung cancer exhibit lower oral medication adherence. Healthcare professionals should encourage family members to provide more attention and support to patients, enhance peer support among patients, and further develop continuity of care. By leveraging their professional expertise, they should conduct targeted health education to improve patients’ self-efficacy in rational medication use and medication beliefs. This will help enhance medication adherence, reduce the occurrence of potentially inappropriate medications (PIM), improve treatment outcomes and quality of life, and assist patients in developing better medication literacy, thereby promoting their recovery.