目的·调查维持性透析患者药物治疗管理过程中安全用药知识、信念、行为（知信行；knowledge， attitude， belief and practice，KAP）现状并分析其相关因素。方法·该研究为横断面研究，选取2019年3月至2021年3月上海交通大学医学院附属第九人民医院肾脏内科的维持性透析患者，使用经过信度、效度验证的慢性肾脏病患者安全用药KAP量表评价其用药安全情况，同时调查其人口学特征、用药清单和临床特征，根据Strand分类系统评估药物相关问题（medication-related problem，MRP）的发生情况。采用单因素分析及多重线性回归分析探索透析患者安全用药KAP水平的相关因素。结果·共纳入187例维持性透析患者，其中103例维持性血液透析患者，84例持续非卧床腹膜透析患者，平均年龄（60.19±12.80）岁，平均透析龄为（44.31±36.90）个月，平均共病（6.37±2.17）种，平均用药（7.48±2.66）种。用药安全KAP量表总分为（77.68±18.53）分，其中安全用药知识平均（24.96±8.92）分，安全用药信念平均（17.19±3.18）分，安全用药行为平均（35.40±8.18）分。单因素分析结果显示：维持性透析患者的安全用药KAP得分在不同透析方式、文化程度、经济水平及是否并发肾性贫血上差异存在统计学意义（均P<0.05），且患者的共病数越多、使用的钙磷代谢药物越多、发生的MRP越多，其安全用药KAP量表得分越低（均P<0.05）。多元线性回归显示：持续非卧床腹膜透析（β=8.391，95%CI 3.436~13.347，P=0.001）、接受过高等教育（β=9.159，95%CI 0.978~17.339，P=0.028）、家庭人均月收入>6 000元（β=8.309，95%CI 1.891~14.727，P=0.011）及共病数更少（β=-1.582，95%CI -2.783~-0.382，P=0.010）、发生的MRP更少（β=-2.284，95%CI -3.987~-0.581，P=0.009）的透析患者安全用药KAP量表得分更高。结论·维持性透析患者的安全用药KAP水平较低，血液透析、低文化程度、低经济水平、高共病数及高MRP数是透析患者安全用药KAP低水平的危险因素。

Objective ·To survey the status quo of knowledge, attitude, belief and practice (KAP) of safe medication in the process of medication therapy management in dialysis patients, and analyze the related factors. Methods ·This study was a cross-sectional study with the maintenance dialysis patients selected from the Department of Nephrology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from March 2019 to March 2021. The KAP scale for safe medication in patients with chronic kidney disease verified by reliability and validity tests was used to evaluate the status quo of safe medication, and their medication list and clinical characteristics were also investigated. The occurrence of medication-related problems (MRPs) was evaluated according to the Strand classification system. The related factors of KAP level of safe medication in the dialysis patients were analyzed by univariate analysis and multiple linear regression analysis. Results ·A total of 187 maintenance dialysis patients were included, including 103 patients with maintenance hemodialysis (MHD) and 84 patients with continuous ambulatory peritoneal dialysis (CAPD). The mean age of them was (60.19±12.80) years, the mean dialysis duration was (44.31±36.90) months, and the mean numbers of comorbidities and medications were 6.37±2.17 and 7.48±2.66, respectively. In the dialysis patients, the mean score of KAP scale was (77.68±18.53) points. The mean scores of knowledge, attitude, and practice of safe medication were (24.96±8.92), (17.19±3.18), and (35.40±8.18) points, respectively. The univariate analysis results showed that there were significant differences of KAP scores for safe medication in the dialysis pattern, the educational level, the economic level and the occurrence of renal anemia in the maintenance dialysis patients (all P<0.05). In addition, the more comorbidities or medications for regulating calcium and phosphorus metabolism the patients had, or the more MRPs occurred, the lower KAP scores for safe medication the patients got (all P<0.05). Multiple linear regression results showed that the dialysis patients with CAPD (β=8.391, 95%CI 3.436?13.347, P=0.001), with higher education (β=9.159, 95%CI 0.978?17.339, P=0.028), with per capita monthly household income of over 6 000 yuan (β=8.309, 95%CI 1.891?14.727, P=0.011), with less comorbidities (β=-1.582, 95%CI -2.783?-0.382, P=0.010), and with less MRPs (β=-2.284, 95%CI -3.987?-0.581, P=0.009) had higher KAP scores. Conclusion ·The KAP level of safe medication in the patients with maintenance dialysis is low. The hemodialysis, low educational level, low economic level, high number of comorbidities, and high number of MRPs are risk factors for low level of KAP of safe medication in dialysis patients.