基于Logistic回归分析艾滋病患者抗病毒治疗依从性的影响因素

摘要:

目的：获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)简称“艾滋病”，AIDS患者在抗病毒治疗过程中的依从性会对治疗结局产生直接影响，本研究旨在探讨AIDS患者抗病毒治疗依从性的相关影响因素，为制订改善依从性干预措施提供科学依据。方法：回顾性选取2020年1月至2024年1月在湖南湘江新区定点医院接受抗病毒治疗的418例AIDS患者为调查对象，依据入组前1周内实际按时(推迟或提前服药≤2 h)服药剂量占医嘱应服药剂量的百分率评估所选对象的抗病毒治疗依从性。统计AIDS患者抗病毒治疗依从性情况，分析AIDS患者抗病毒治疗依从性的影响因素，并利用多因素Logistic回归分析AIDS患者抗病毒治疗依从性的危险因素。结果：418例AIDS患者中，抗病毒治疗依从性差者81例，依从性好者337例。依从性差组与依从性好组患者学历、焦虑情况、AIDS基本知识知晓情况、确诊至开始治疗时间、治疗方案(联合用药种类)、用药后不良反应比较，差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示，学历为初中及以下[比值比(odds ratio,OR)=1.090)]、焦虑为临界/明显(OR=1.087)、AIDS基本知识不知晓(OR=1.093)、确诊至开始治疗时间为1～256个月(OR=2.757)、治疗方案(联合用药种类)≥3种(OR=2.942)、用药后有不良反应(OR=1.099)是AIDS患者抗病毒治疗依从性差的独立危险因素(均P<0.05)。结论：AIDS患者抗病毒治疗依从性与学历、焦虑情况、AIDS基本知识知晓情况、确诊至开始治疗时间、治疗方案(联合用药种类)、用药后不良反应密切相关，临床可据此给予AIDS患者针对性的预防策略，以提高其抗病毒治疗依从性。

Abstract:

ObjectiveAdherence to antiretroviral therapy in patients with acquired immune deficiency syndrome (AIDS) directly impacts treatment outcomes. This study aims to explore the factors influencing adherence to antiretroviral therapy in AIDS patients, providing a scientific basis for developing interventions to improve adherence.MethodsA retrospective study was conducted with 418 AIDS patients who received antiretroviral therapy at a designated hospital in the Hunan Xiangjiang New District from January 2020 to January 2024. Adherence to antiretroviral therapy was assessed based on the percentage of prescribed doses taken on time (within 2 hours) during the week prior to the study. The study analyzed the factors related to antiretroviral therapy adherence and used multivariate logistic regression to identify risk factors for poor adherence.ResultsAmong the 418 AIDS patients, 81 had poor adherence, while 337 had good adherence. There were statistically significant differences between the poor and good adherence groups in terms of education level, anxiety, knowledge of basic AIDS information, time from diagnosis to treatment initiation, treatment regimen (number of combined drugs), and adverse drug reactions (all P<0.05). Multivariate Logistic regression analysis indicated that factors such as education level of junior high school or below [odds ratio (OR)=1.090], borderline/significant anxiety (OR=1.087), lack of basic AIDS knowledge (OR=1.093), time from diagnosis to treatment initiation of 1 to 256 months (OR=2.757), treatment regimens with three or more drugs (OR=2.942), and adverse reactions (OR=1.099) were independent risk factors for poor adherence to antiretroviral therapy in AIDS patients (all P<0.05).ConclusionAdherence to antiretroviral therapy in AIDS patients is closely related to education level, anxiety, knowledge of basic AIDS information, time from diagnosis to treatment initiation, treatment regimen, and adverse drug reactions. Clinically, targeted prevention strategies should be developed based on these factors to improve adherence to antiretroviral therapy in AIDS patients.