Abstract：Objective To systematically evaluate the intervention effect of family physician management on medication adherence among patients with chronic diseases in the community, so as to provide the evidence for improving the health status of patients with chronic diseases. Methods Randomized controlled trials regarding the intervention effect of family physician management on medication adherence among community-dwelling patients with chronic diseases in China were retrieved from CNKI, Wanfang Data, VIP, China Medical Literature Service System, PubMed, Web of Science, and Embase from inception to April 30, 2025. Meta-analysis was performed using RevMan 5.4 and R 4.5.1 software. Sensitivity analysis was conducted by excluding studies one by one, and Egger's regression test was used to assess publication bias. Results A total of 429 articles were initially screened, and 11 Chinese studies involving 3 574 patients with chronic diseases in the community were finally included. Meta-analysis showed that family physician management significantly improved medication adherence (RR=1.400, 95%CI: 1.175-1.668). Subgroup analysis showed significant differences in the intervention effect across subgroups stratified by research setting and outcome measurement tools (all P<0.05). Sensitivity analysis confirmed the robustness of the pooled results. Egger's regression test indicated publication bias. After adjustment by the trim-and-fill method, the direction of the pooled RR value remained unchanged, confirming robust findings. Conclusions Family physician management can effectively improve medication adherence among community-dwelling patients with chronic diseases in China. It is necessary to further implement contracted family physician services to promote the health of patients with chronic diseases.
元秋香, 颜家宝, 张丝雨, 李佳雪, 刘雅欣, 陈长生. 家庭医生管理对社区慢性病患者服药依从性干预效果的Meta分析[J]. 预防医学, 2026, 38(7): 706-710.
YUAN Qiuxiang, YAN Jiabao, ZHANG Siyu, LI Jiaxue, LIU Yaxin, CHEN Changsheng. Effectiveness of family physician-led interventions on medication adherence among patients with chronic diseases in the community: a meta-analysis. Preventive Medicine, 2026, 38(7): 706-710.
[1] 陈鸣声.家庭医生签约服务的重点范畴与优化方向[J].人民论坛,2025(20):56-59. [2] Varma P,Mohandas A,Ravulapalli P,et al.A cross-sectional study on adherence to treatment and life-style modifications in hypertensive patients attending the urban health centre of a teaching hospital in Hyderabad[J].J Family Med Prim Care,2023,12(12):3129-3134. [3] 王学华.家庭医生签约服务对老年高血压患者服药依从性及血压管理水平的影响[J].中国社区医师,2024,40(23):140-142. [4] 唐雪,丁露露,冯月静,等.家庭医生签约服务对农村冠心病患者服药依从性影响研究[J].中国农村卫生事业管理,2020,40(4):240-245. [5] 国务院办公厅.国务院办公厅关于印发中国防治慢性病中长期规划(2017—2025年)的通知[EB/OL].[2026-04-23].https://www.gov.cn/zhengce/content/2017-02/14/content_5167886.htm. [6] 郝杰,于翰.130例老年2型糖尿病患者长期用药依从性的调查与分析[J].中国医院药学杂志,2019,39(16):1687-1690. [7] Higgins J P T,Altman D G,Gotzsche P C,et al.The Cochrane Collaboration's tool for assessing risk of bias in randomised trials[J/OL].BMJ,2011,343[2026-04-23].https://doi.org/10.1136/bmj.d5928. [8] 李冰,吴泓悦,王紫丹,等.不同非药物干预方式缓解肺癌术后急性疼痛的网状Meta分析[J/OL].中国胸心血管外科临床杂志,2026[2026-04-23].https://link.cnki.net/urlid/51.1492.R.20260414.1716.002. [9] Flumignan R L,Civile V T,Tinôco J D de S,et al.Anticoagulants for people hospitalised with COVID-19:a rapid review[J/OL].Cochrane Database Syst Rev,2026,(4)[2026-04-23].http://doi.org/10.1002/14651858.CD013739.pub2. [10] 杨存玲.探讨全科医生对社区糖尿病患者健康管理的作用[J].中国卫生标准管理,2018,9(4):59-61. [11] 杨容,卞蓉民,陈虹,等.家庭医生工作室开展社区高血压患者合理用药药学服务效应探索[J].现代消化及介入诊疗,2022,27(S1):1472. [12] 牛磊.家庭医生签约对社区高血压患者治疗效果的影响[D].芜湖:皖南医学院,2022:5-10. [13] 张婕,陈玉荣,刘春凡.家庭医生签约式服务模式对社区糖尿病患者健康促进行为及血糖控制效果的影响[J].临床护理杂志,2019,18(5):6-8. [14] 郑秀丽.通过家庭医生签约方式对社区糖尿病患者实施健康干预的效果[J].糖尿病新世界,2021,24(12):170-173. [15] 陈丽,冯印球.家庭医生服务团队提高肺结核病患者居家服药依从性的效果分析[J].中西医结合护理(中英文),2019,30(6):120-122. [16] 李海峰,龚一鸣,熊杰,等.糖尿病患者不同管理模式的效果分析[J].中国医药指南,2015,13(2):59-60. [17] 王清鹏,涂江虹,陈燕玲.家庭医生制服务在高血压患者家庭管理中的应用[J].海南医学,2019,30(9):1167-1169. [18] 金立.家庭医生督导对消化性溃疡患者转归的影响[J].上海医药,2018,39(10):44-46,56. [19] 刘昊.全科医生提高社区高血压患者用药依从性的效果研究[J].临床合理用药杂志,2012,5(18):8-9. [20] 廖宇佳,陈秀香,彭筱平.家庭医生团队对高血压患者进行规范化管理的效果评价[J].中国医药导刊,2023,25(2):192-198. [21] Tong X,Zou H,Zhang L,et al.Impact of the family doctor system on medication adherence among type 2 diabetes patients in China: a difference-in-differences analysis[J/OL].BMC Public Health,2025,25[2026-04-23].http://doi.org/10.1186/s12889-025-21656-0. [22] 何艳平,张晓丹,姚强.家庭医生签约服务的健康效应及作用机制研究——来自6省12县1 191位农村慢性病患者的证据[J].中国卫生政策研究,2024,17(8):19-27. [23] 费婧娴,邹鑫,程应华,等.家庭医生信任与2型糖尿病患者服药依从性的关系研究[J].中华医院管理杂志,2019,35(2):151-155. [24] 胡宴杰.社区家庭医生参与用药指导对提高临床安全用药效果的研究[J].中国社区医师,2015,31(26):7-9. [25] Liu Q,Ren B Q,Yin L,et al.Effects of a family-doctor-led community intervention model on self-management and medication taking in patients with type 2 diabetes mellitus:a randomized controlled trial[J/OL].BMC Public Health,2025,25[2026-04-23] http://doi.org./10.1136/bmjopen-2021-058670. [26] Qin A,Qin W,Hu F,et al.Does unequal economic development contribute to the inequitable distribution of healthcare resources evidence from China spanning 2001-2020[J/OL].Global Health,2024,20(1)[2026-04-23].http://doi.org/10.1186/s12992-024-01025-z. [27] 许日祥,沐婷玉,倪晓莉,等.中国高血压患者用药依从性的meta分析[J].中国现代应用药学,2020,37(19):2383-2389.
