Shaw E, Anderson J G, Maloney M, Jay S J, Fagan D
Indiana University School of Medicine, Indianapolis.
Hosp Pharm. 1995 Mar;30(3):201-3, 206-7.
Poor adherence to drug therapy decreases the effectiveness of antihypertensive treatment. Patients must take more than 80% of their antihypertensive drugs to maintain adequate blood pressure control. To understand the incidence of noncompliance and contributing factors, a pilot study was conducted in which a questionnaire was devised and administered to a random sample of 243 hypertensive patients of the adult ambulatory care clinic at Methodist Hospital of Indiana. Ninety-eight patients completed the telephone survey. Demographic data were obtained through chart reviews. The results indicated that 30-46% of the patients were noncompliant with their antihypertensive drug regimens. Factors found to be associated with noncompliance were; employment (P = .0077), use of home remedies (P = .0043), age (P = .0165), experience of side effects (P = .0051), level of concern with missed doses (P = .0043), and cost (P = .014). The incidence of noncompliance in this pilot sample is lower than the estimated 50% noncompliance rate of published data. More research is needed to understand the determinants of noncompliance in order to design interventions to improve compliance.
药物治疗依从性差会降低抗高血压治疗的效果。患者必须服用超过80%的抗高血压药物才能维持足够的血压控制。为了解不依从的发生率及相关因素,开展了一项试点研究,设计了一份问卷并发放给印第安纳卫理公会医院成人门诊护理诊所的243名高血压患者随机样本。98名患者完成了电话调查。通过病历审查获取人口统计学数据。结果表明,30 - 46%的患者未依从其抗高血压药物治疗方案。发现与不依从相关的因素有:就业情况(P = .0077)、使用家庭疗法(P = .0043)、年龄(P = .0165)、副作用经历(P = .0051)、对漏服药物的关注程度(P = .0043)以及费用(P = .014)。该试点样本中的不依从发生率低于已发表数据估计的50%不依从率。需要开展更多研究以了解不依从的决定因素,从而设计干预措施来提高依从性。