华南预防医学 ›› 2025, Vol. 51 ›› Issue (7): 736-740.doi: 10.12183/j.scjpm.2025.0736

• 论著 • 上一篇    下一篇

中山地区居民用药安全知信行及其影响因素调查

郑燕鸣1,2, 李伊凡3, 闫译文3, 林凯程4   

  1. 1.南方医科大学卫生管理学院,广东 广州 510000;
    2.广州医科大学附属中医医院;
    3.广州医科大学;
    4.南方医科大学南方医院
  • 收稿日期:2024-12-13 出版日期:2025-07-20 发布日期:2025-08-25
  • 通讯作者: 林凯程,E-mail:kanlpp@163.com
  • 作者简介:郑燕鸣(1991—),女,大学本科,卫生管理助理研究员,研究方向:卫生管理
  • 基金资助:
    广东省卫生经济学会面上课题(2021-WJMZ-26)

Knowledge, attitudes and practices of medication safety and their influencing factors among residents in Zhongshan

ZHENG Yanming1,2, LI Yifan3, YAN Yiwen3, LIN Kaicheng4   

  1. 1. School of Health Management, Southern Medical University, Guangzhou, Guangdong 510000, China;
    2. Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University;
    3. Guangzhou Medical University;
    4. Nanfang Hospital, Southern Medical University
  • Received:2024-12-13 Online:2025-07-20 Published:2025-08-25

摘要: 目的 调查中山地区居民用药安全知信行现状及影响因素,为提升该地区居民安全用药水平提供依据。方法 2024年1—2月通过分层抽样法对中山地区居民用药安全知信行进行调查,以描述性分析方法对该地区居民用药安全的知识、态度和行为现状进行分析,以单因素及多因素logistic回归分析方法对居民用药安全的知识、态度和行为的影响因素进行分析。结果 共发放720份问卷,回收有效问卷683份,回收率94.86%。居民用药安全的知识优良率为72.62%(496/683),优势项目包括遵医嘱用药依从率96.30%和阅读药物说明书89.50%,薄弱环节如服药注意事项知晓率仅58.20%、特殊剂型服用方法掌握率为61.70%。居民用药安全态度优良率为68.37%(467/683),其中对基本药物制度高度认可91.40%,对具体制度的知晓率仅为49.80%;药物不良反应报告意识和定期清理药箱意识较弱,分别为62.10%和65.30%。居民用药安全行为优良率为65.01%(444/683),药物储存行为达标率为52.40%,过期药物处理不当率为58.90%,用药记录缺失率为63.20%,药物说明书的阅读率较高(85.70%)。多因素logistic回归分析结果显示,中山地区居民用药安全知识优良率随年龄增长而下降(OR=0.784),随文化程度升高而升高(大专及以上OR=2.504),城镇居民高于农村(OR=1.751),有慢性病史者高于无病史者(OR=2.056);用药安全态度优良率女性高于男性(OR=1.536),随年龄增加而降低(OR=0.894),文化程度越高越积极(OR=1.762),工农职业者低于其他职业(OR=0.911),城镇居民优于农村(OR=1.441),参加医保(OR=2.301)和农村合作医疗(OR=2.056)均优于自费;用药安全行为优良率亦呈女性优于男性(OR=2.013)、年龄越大越差(OR=0.840)、文化程度越高越好(OR=1.652)、与家人同住优于独居(OR=1.843)、医保(OR=2.337)及农村合作医疗(OR=1.926)优于自费,而有慢性病史者行为表现较差(OR=0.842)(均P<0.05)。结论 本研究基于KAP框架,通过问卷与多因素回归分析,证实需以高龄、低文化程度、独居、慢性病人群为重点,构建“数字化指导—医保协同”闭环干预,方能实现中山地区居民用药安全水平整体跃升。

关键词: 用药安全, 合理用药, 知识,态度,实践, 药物不良反应, 药物储存, 健康教育

Abstract: Objective To investigate the status of medication safety knowledge, attitudes, and practices (KAP) among residents in Zhongshan and to identify associated influencing factors, thereby providing an evidence base for enhancing regional medication safety standards. Methods Between January and February 2024, a stratified sampling method was employed to survey the medication safety KAP of residents in Zhongshan. Descriptive statistics were used to analyze the current status of medication safety KAP. Univariate and multivariate logistic regression analyses were conducted to determine the influencing factors. Results A total of 720 questionnaires were distributed, and 683 valid responses were collected, yielding a response rate of 94.86%. The prevalence of adequate knowledge regarding medication safety was 72.62% (496/683). Areas of strength included high adherence to prescribed medication (96.30%) and a high rate of reading drug information leaflets (89.50%). However, significant deficiencies were observed, including low awareness of medication precautions (58.20%) and insufficient understanding of administration methods for special dosage forms (61.70%). The prevalence of favorable attitudes towards medication safety was 68.37% (467/683). Although there was high approval for the national essential medicine system (91.40%), awareness of its specific policies was merely 49.80%. Consciousness regarding reporting adverse drug reactions and periodically organizing home medicine cabinets was relatively low, at 62.10% and 65.30%, respectively. The prevalence of appropriate medication practices was 65.01% (444/683). The compliance rate for correct drug storage was 52.40%, while the rate of improper disposal of expired medications was 58.90%, and 63.20% of participants did not maintain medication records. The rate of reading drug information leaflets, however, was high at 85.70%. Multivariate logistic regression analysis indicated that adequate medication safety knowledge was negatively associated with increasing age (OR=0.784) but positively associated with higher educational attainment (college or above: OR=2.504), urban residence (vs. rural: OR=1.751), and a history of chronic disease (vs. no history: OR=2.056). Favorable attitudes were more prevalent in females (vs. males: OR=1.536), decreased with age (OR=0.894), increased with higher education levels (OR=1.762), and were higher among urban residents (vs. rural: OR=1.441) and those with medical insurance (OR=2.301) or new rural cooperative medical scheme coverage (OR=2.056) compared to self-paying individuals; industrial and agricultural workers exhibited less favorable attitudes than other occupational groups (OR=0.911). Similarly, appropriate practices were more common in females (vs. males: OR=2.013), decreased with age (OR=0.840), improved with higher education (OR=1.652), and were more prevalent among those living with family (vs. living alone: OR=1.843) and those with medical insurance (OR=2.337) or rural cooperative medical coverage (OR=1.926) compared to self-payers. Conversely, individuals with a history of chronic disease demonstrated poorer practices (OR=0.842). Conclusions Utilizing the KAP framework, this study confirms through survey and multivariate regression analyses that individuals who are elderly, have lower educational attainment, live alone, and suffer from chronic diseases should be the primary focus of interventions. The findings suggest that establishing a closed-loop intervention model that integrates digital guidance with health insurance coordination is imperative for achieving a comprehensive enhancement of medication safety levels among the residents of Zhongshan.

Key words: Medication safety, Rational drug use, Knowledge,attitudes and practices (KAP), Adverse drug reactions, Drug storage, Health education

中图分类号: 

  • R193.8