关键词: 肾病, 服药依从性, 中医药, 专家咨询

Abstract: Objective　To explore the associated factors for the adherence to prescribed Chinese and Western medications in patients with chronic kidney disease（CKD） by using the Delphi consultation.Methods　In this study carried out between April and September 2017，we recruited 23 experts in the field of Chinese and Western medicine nephrosis，and conducted a three-round Delphi expert consultation for investigating their appraisal of each item in our pre-designed knowledge-belief-behavior based questionnaire.Results　Total 44 items were formed after three-round expert consultation.The knowledge part comprises 18 items（e.g.curative effects，side effects，naming and methods of administration），each of them achieved over 90% recognition rate.Nineteen items（e.g.harmonious interaction，clear mind，and relaxed mood due to medication） constitute the belief part，and 12 out of them（e.g.richer energy，lower likelihood of hospitalization，and relaxed mood after medication） won over 90% recognition rate.The behavior part consists of 7 items（e.g.missing medication，overlooked medication，medication cessation against prescription after symptomatic relief），5 of which（e.g.missing medication，overlooked medication，medication cessation against prescription after symptomatic relief） gained over 90% recognition rate.Conclusion　The factors affecting the compliance of CKD patients include the degree of patients' understanding of daily medication, the understanding of  decocting of Chinese medicine and the acceptance of the taste of traditional Chinese medicine, the self feeling after taking the medicine, the effect and prognosis of the treatment, and the influence of daily life on the medicine.Patient education focusing on significant associated factors for medication adherence to boost positive medication belief and avoid negative medication belief may improve medication adherence in patients with CKD and clinical benefits.

Key words: Nephrosis, Medication adherence, Traditional Chinese medicine, Expert consultation