目的：探讨服药依从性相关主观因素改善对提高阿尔茨海默病（Alzheimer’s disease，AD）患者服药依从性的效应。

方法：前瞻性收集2014年12月—2017年10月符合病例选择标准的30例AD患者，其中1例于研究期间退出，其余29例完成9个月的研究。改善服药依从性相关主观因素的措施包括：对患者进行宣传教育，增加面谈和电话访视次数，建立患者档案；由药物发放者负责药物发放和回收；提高看护者对服药依从性的重视及配合程度，记录服药卡，监督服药。采用药片计数法计算服药依从率。将本研究的平均服药依从率与美国、荷兰、澳大利亚、印度、韩国和中国台湾地区报道的服药依从率以及标准服药依从性良好率（80%）和优秀率（90%）进行统计学比较。

结果：本研究中，总的9个月的平均服药依从率为92.3%±13.9%，全程服药依从性良好率和优秀率分别为88.9%和79.5%；第9个月末的平均服药依从率为92.1%±13.2%，服药依从性良好率和优秀率分别为84.6%和80.8%。本研究总的9个月的平均服药依从率均显著高于文献报道的平均服药依从率（P＜0.001）；第9个月末的平均服药依从率亦高于除中国台湾地区文献以外其他文献报道的结果（P＜0.001）。本研究的服药依从率显著高于标准服药依从性良好率（P＜0.001），但是与标准服药依从性优秀率的差异无统计学意义（P＞0.05）。

结论：通过改善医护人员和看护者的主观因素，可以提高AD患者的服药依从性。

Objective: To investigate the effect of improving the subjective factors on medication adherence of patients with Alzheimer’s disease (AD).

Methods: Thirty patients with AD who met the criteria of case selection from December 2014 to October 2017 were prospectively enrolled. One of them dropped out during the study period, and the remaining 29 patients completed the 9-month study. The measures to improve the subjective factors related to medication adherence included publicizing and educating patients, increasing the number of interviews and telephone visits, establishing patient files; the pharmacist was responsible for drug distribution and take-back; improving the attention and cooperation of caregivers on medication adherence, recording medication cards and supervising medication. The medication adherence was calculated by pill counts. The average medication adherence of the study was compared with those reported in literatures from United States, Netherlands, Australia, India, South Korea and Taiwan of China, as well as the standard good (80%) and excellent (90%) medication adherence.

Results: In this study, the average medication adherence rate was 92.3% ± 13.9%, and the good and excellent medication adherence rates were 88.9% and 79.5%, respectively in the study period of 9 months; the average medication adherence rate was 92.1% ± 13.2%, and the good and excellent rates were 84.6% and 80.8%, respectively at the end of the 9th month. The average medication adherence rate in the study period of 9 months was significantly higher than those reported in other literatures (P < 0.001). The average medication adherence rate at the end of the 9th month was also higher than those reported in other literatures except Taiwan of China (P < 0.001). The medication compliance rate was significantly higher than the standard good medication adherence (P < 0.001), but had no significant difference as compared with the standard excellent medication adherence (P > 0.05).

Conclusion: The medication adherence of patients can be enhanced by improving the subjective factors of healthcare providers and caregivers.