关键词: 冠心病, 老年人, 用药偏差, 潜类别增长模型, 纵向研究, 护理

Abstract:

Objective To explore the latent classes of medication deviation trajectories and their influencing factors in elderly patients with coronary heart disease（CHD），and to provide a theoretical basis for targeted clinical interventions.Methods A total of 285 elderly patients with CHD，hospitalized in a tertiary hospital in Guilin from March 2024 to March 2025，were selected using convenience sampling. A general information questionnaire，the Frailty Scale，and the Drug Literacy Questionnaire were used for the baseline survey. The Medication Deviation Assessment Tool was used to collect data at 4 time points：1 week（T1），1 month（T2），3 months（T3），and 6 months（T4） after discharge. Latent Class Growth Modeling（LCGM） was used to identify the latent classes of medication deviation trajectories，and multivariate logistic regression analysis was employed to explore the influencing factors.Results A total of 253 patients were ultimately included. The incidence of medication deviation at the 4 time points was 37.5%，63.2%，70.7%，and 79.8%，respectively. Totally 3 distinct latent classes were identified：a rapid deterioration group（34.0%），a stable maintenance group（29.3%），and a persistent deviation group（36.8%）. Drug literacy，frailty，educational level，duration of illness，number of medications，and whether percutaneous coronary inter-vention（PCI） was received were influencing factors for the latent classes of medication deviation trajectories（P<0.05）.Conclusion Medication deviation in elderly patients with CHD shows a general upward trend with heterogeneous developmental trajectories among subgroups. Healthcare professionals can carry out targeted interventions based on the influencing factors of these trajectories.

Key words: Coronary Heart Disease, Elderly, Medication Deviation, Latent Class Growth Model, Longitudinal Studies, Nursing Care