Abstract: Background The elderly often suffer from a variety of chronic diseases and require multiple drug treatments. However，many patients struggle to sustain or standardize their medication due to various factors，leading to poor disease control and unsatisfactory medical outcomes. Therefore，understanding the current status and influencing factors of medication adherence among the elderly is crucial for improving and enhancing their adherence. Shandong Province，one of the most populous provinces in China，is at the forefront of the country in terms of aging. The overall medication compliance among the elderly in Shandong is poor，characterized by frequent changes in medication timing，missed doses，or incorrect dosages. As a result，medication adherence among the elderly in Shandong has become a key factor affecting treatment efficacy and quality of life. Objective This study aims to explore the medication adherence among elderly individuals in Shandong Province under the active health management model，and to analyze the factors influencing their medication adherence，thereby providing an effective reference for the management of medication behavior in this population. Methods A total of 5 447 elderly individuals aged 65 and above were selected from 100 basic community units in Shandong Province using a multi-stage random sampling method. The survey content included basic sociodemographic information，health-related knowledge，health-related attitudes，health-related behaviors，medication adherence，and quality of life. The chi-square test was used to compare the scores of chronic disease knowledge，beliefs，behaviors and quality of life among the elderly. Multivariate Logistic regression analysis was employed to explore the factors influencing medication adherence in this population. Results Among the 5 447 elderly individuals included in the study，the score on the Morisky scale was（6.33±1.31）. Of these，4 480（82.25%）had good medication adherence，while 967（17.75%）had poor adherence. Logistic regression analysis revealed that gender（OR=0.86，95%CI=0.74~0.99，P=0.038），marital status（OR=0.90，95%CI=0.82~0.98，P=0.017），health-related attitudes（OR=0.78，95%CI=0.68~0.90，P<0.001），willingness to change behavior（OR=0.51，95%CI=0.41~0.65，P<0.001），and quality of life（OR=0.66，95%CI=0.57~0.77，P<0.001）were significant factors influencing medication adherence among the elderly. Conclusion The medication adherence of the elderly in Shandong Province is generally good. However，factors such as health related attitudes，willingness to change behavior，and quality of life significantly impact adherence. Therefore，these factors should be prioritized in the development of intervention strategies to improve medication adherence among the elderly.

Key words: Medication adherence, Chronic disease, Aged, Cross-sectional studies, Shandong Province

摘要： 背景 老年人常患多种慢性病，需要接受多种药物治疗，不少患者会因种种因素难以持续或规范用药，导致病情控制效果差及不理想的医疗结果，因此了解老年人的服药依从行为现状及其影响因素对于改善和提高服药依从性有重要意义。而山东省作为中国人口大省之一，老龄化程度在全国范围内处于领先地位，服药依从性整体情况不佳，表现为经常改变服药时间、漏服或错服等，因此山东省老年人的服药依从性问题成为影响治疗效果和生活质量的关键因素。目的 探讨主动健康管理模式下山东省老年人服药依从性情况，并分析影响其服药依从性的因素，为该地区老年人服药行为管理提供有效的参考依据。方法 采用多阶段随机抽样方法，共抽取山东省 100 个基本社区单位的 5 447 名 65 岁以上的老年人进行问卷调查，调研内容主要包括社会人口学基本信息、健康相关知识、健康相关态度、健康相关行为、服药依从性和生命质量等内容，采用 χ2 检验比较老年人慢病知信行及生命质量的得分情况，采用多因素 Logistic 回归分析探讨山东省老年人服药依从性的影响因素。结果 纳入研究的老年人共 5 447 人，Morisky量表得分为（6.33±1.31）分，其中服药依从性良好者 4 480 例（82.25%），服药依从性不良者 967 例（17.75%）。多因素 Logistic 回归分析表明性别（OR=0.86，95%CI=0.74~0.99，P=0.038）、婚姻状况（OR=0.90，95%CI=0.82~0.98，P=0.017）、健康相关态度（OR=0.78，95%CI=0.68~0.90，P<0.001）、行为改变意愿（OR=0.51，95%CI=0.41~0.65，P<0.001）及生命质量（OR=0.66，95%CI=0.57~0.77，P<0.001）是影响老年人服药依从性的影响因素。结论 山东省老年人服药依从性良好，且健康相关态度、行为改变意愿和生命质量等多种因素显著影响了服药依从性，在制定老年人服药依从性干预策略中，应加强对这些因素的管理。

关键词: 服药依从性, 慢性病, 老年人, 横断面研究, 山东省