Influencing factors for medication adherence among inpatients with chronic diseases based on latent profile analysis
WANG Xiaoshan1,2, YE Lixiang1,2, CHEN Li1, LI Minxiang2, WANG Xinyu1, CAI Xiaoxia1
1. School of International Nursing, Hainan Medical University, Haikou, Hainan 571199, China; 2. Department of Nursing, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570216, China
Abstract：Objective To explore the types of medication adherence and their influencing factors among inpatients with chronic diseases based on latent profile analysis, so as to provide the basis for improving medication adherence among patients with chronic diseases. Methods The inpatients with chronic diseases admitted to the Second Affiliated Hospital of Hainan Medical University were selected as the study subjects. Demographic information, chronic disease status, and health education were collected through questionnaire surveys. Medication adherence was assessed using the Medication Adherence Scale and categorized based on the scores of its eight items through latent profile analysis. Factors affecting medication adherence among inpatients with chronic diseases were analyzed using a multinomial logistic regression model. Results Totally 290 valid questionnaires were recovered, with an effective recovery rate of 97.64%. There were 157 males (54.14%) and 133 females (45.86%), with a median age of 61 (interquartile range, 21) years. The median score of medication adherence was 4.75 (interquartile range, 4.50). Based on latent profile analysis, medication adherence was categorized into three types: subjective neglect with poor adherence (38.97%), subjective confidence with fluctuating adherence (28.28%), and self-reflective with good adherence (32.76%). Multinomial logistic regression analysis showed that compared to the subjective confidence with fluctuating adherence, family monthly income (5 000-10 000 yuan, OR=2.981, 95%CI: 1.055-8.429), comorbidity of chronic diseases (OR=3.478, 95%CI: 1.579-7.661), number of health education sessions received in the past year (≤1 session, OR=0.329, 95%CI: 0.120-0.907; 2 sessions, OR=0.363, 95%CI: 0.138-0.950), and health information literacy scores (<60 points, OR=2.596, 95%CI: 1.209-5.573) were statistically associated with subjective neglect with poor adherence (all P<0.05). Conclusion Subjective neglect with poor medication adherence among inpatients with chronic diseases is associated with family monthly income, comorbidity of chronic diseases, the number of health education sessions received, and health information literacy.
王晓闪, 叶丽香, 陈莉, 李敏香, 王心语, 蔡小霞. 基于潜在剖面分析的慢性病住院患者服药依从性影响因素分析[J]. 预防医学, 2025, 37(3): 217-222.
WANG Xiaoshan, YE Lixiang, CHEN Li, LI Minxiang, WANG Xinyu, CAI Xiaoxia. Influencing factors for medication adherence among inpatients with chronic diseases based on latent profile analysis. Preventive Medicine, 2025, 37(3): 217-222.
[1] 江佳艳,李静,戴丹华,等.老年慢性病患者服药依从性与生命质量相关性分析[J].中国初级卫生保健,2022,8(10):46-50. JIANG J Y,LI J,DAI D H,et al.Correlation analysis of medication compliance and quality of life in elderly patients with chronic diseases in community[J].Chin Prim Health Care,2022,8(10):46-50.(in Chinese) [2] NEIMAN A B,RUPPAR T,HO M,et al.CDC grand rounds:improving medication adherence for chronic disease management-innovations and opportunities[J].MMWR,2017,66(45):1248-1251. [3] LENTI M V,SELINGER C P.Medication non-adherence in adult patients affected by inflammatory bowel disease:a critical review and update of the determining factors,consequences and possible interventions[J].Expert Rev Gastroenterol Hepatol,2017,11(3):215-226. [4] 刘宇丹,张彩云,郭明媚,等.慢性病共病患者服药依从性影响因素的Meta分析[J].预防医学,2024,36(9):790-795,800. LIU Y D,ZHANG C Y,GUO M M,et al.Influencing factors for medication compliance in patients with comorbidities of chronic diseases:a meta-analysis[J].China Prev Med J,2024,36(9):790-795,800.(in Chinese) [5] 陈国伶,沈勤,卢晓杰,等.2型糖尿病患者医养护一体化签约服务管理效果评价[J].预防医学,2019,31(1):100-102. CHEN G L,SHEN Q,LU X J,et al.Effectiveness evaluation of the integrated medical-nursing-care contract service management for patients with type 2 diabetes mellitus[J].China Prev Med J,2019,31(1):100-102.(in Chinese) [6] 王辅之,罗爱静,谢文照,等.健康信息素养自评量表的编制及其信效度检验[J].中国现代医学杂志,2013,23(30):89-93. WANG F Z,LUO A J,XIE W Z,et al.Development of health information literacy self-rating scale and its reliability and validity test[J].China J Mod Med,2013,23(30):89-93.(in Chinese) [7] MORISKY D E,ANG A,KROUSEL-WOOD M,et al.Predictive validity of a medication adherence measure in an outpatient setting[J].J Clin Hyperten,2008,10(5):348-354. [8] 温忠麟,谢晋艳,王惠惠.潜在类别模型的原理、步骤及程序[J].华东师范大学学报(教育科学版),2023,41(1):1-15. WEN Z L,XIE J Y,WANG H H.Principles,procedures and programs of latent class models[J].J East China Norm Univ(Educational Sci),2023,41(1):1-15.(in Chinese) [9] TEIN J Y,COXE S,CHAM H.Statistical power to detect the correct number of classes in latent profile analysis[J].Struct Equ Modeling,2013,20(4):640-657. [10] 吴丽红,刘宇,宋桂云,等.住院老年慢性病病人服药依从性与健康素养的相关性研究[J].护理研究,2018,32(11):1803-1806. WU L H,LIU Y,SONG G Y,et al.Correlation between drug compliance and health literacy in hospitalized elderly patients with chronic diseases[J].Chin Nurs Res,2018,32(11):1803-1806.(in Chinese) [11] 关倍倍,陈长香.自理能力和病前行为习惯对脑卒中高血压共病患者记忆功能的影响[J].现代预防医学,2020,47(10):1837-1839,1883. GUAN B B,CHEN C X.Effects of self-care ability and premorbid behavior on memory function in patients with stroke and hypertension[J].Mod Prev Med J,2020,47(10):1837-1839,1883.(in Chinese) [12] 汤华萍,李刚,方芳,等.针对性记忆策略对老年糖尿病患者认知及记忆功能的影响[J].中国老年学杂志,2021,41(21):4765-4767. TANG H P,LI G,FANG F,et al.The impact of targeted memory strategies on cognition and memory function in elderly patients with diabetes mellitus[J].Chin J Gerontol,2021,41(21):4765-4767.(in Chinese) [13] 罗发燕,陈铁霞,罗平平,等.慢性乙型肝炎患者服药依从性调查[J].预防医学,2023,35(11):966-969,974. LUO F Y,CHEN T X,LUO P P,et al.Medication adherence among patients with chronic hepatitis B[J].China Prev Med J,2023,35(11):966-969,974.(in Chinese) [14] 陈维尔,邱艳,潘晓华,等.我国共病患者服药依从性的研究进展[J].中华全科医学,2023,21(10):1745-1748. CHEN W E,QIU Y,PAN X H,et al.Progress on medication compliance of patients with multimorbidity in China[J].Chin J Gen Prac,2023,21(10):1745-1748.(in Chinese) [15] 张振香,何福培,张春慧,等.慢性病共病患者服药依从性潜在类别及其影响因素分析[J].中国全科医学,2022,25(31):3904-3913. ZHANG Z X,HE F P,ZHANG C H,et al.Latent class analysis and influencing factors of medication adherence in multiple chronic conditions patients[J].Chin Gen Pract,2022,25(31):3904-3913.(in Chinese) [16] 吴记红,吴记梅,刘小加.慢性阻塞性肺疾病患者健康信息素养现状及影响因素分析[J].沈阳医学院学报,2024,26(4):370-375. WU J H,WU J M,LIU X J.Analysis of the current situation and influencing factors of health information literacy in patients with chronic obstructive pulmonary disease[J].J Shenyang Medical Coll,2024,26(4):370-375.(in Chinese) [17] 赵鑫,刘雨欣,段棣飞,等.慢性肾脏病患者健康信息素养与服药依从性的相关性[J].中国临床研究,2022,35(6):875-879. ZHAO X,LIU Y X,DUAN D F,et al.Correlation of health information literacy and medication adherence in patients with chronic kidney disease[J].Chin J Clin Res,2022,35(6):875-879.(in Chinese)
