Rudd P
Stanford University School of Medicine, CA 94305, USA.
Am J Manag Care. 1998 Jul;4(7):957-66.
Recent advances in the effectiveness of antihypertensive therapies and the measurement of medication-taking behavior have raised the bar of expectations, both for patients and prescribing clinicians. This article reviews the principal findings and makes recommendations to improve pill taking among patients with hypertension. It summarizes several studies related to hypertension epidemiology, component behaviors contributing to suboptimal compliance with prescribed antihypertensive medications, the direct and indirect costs of nonadherent behaviors, and measures of pill-taking behavior. Based on this analysis, current levels of hypertension detection, treatment, and control remain suboptimal. Heuristics for adjusting antihypertensive regimens may be misleading and too simplistic. More than half of those patients failing to achieve goal blood pressure display suboptimal compliance rather than an inadequate regimen. In conclusion, there is a need for enhanced sophistication about medication-taking behavior, especially for hypertension, so that more patients with this condition can fully benefit from effective treatments.
抗高血压治疗效果及服药行为测量方面的最新进展，提高了患者和开处方的临床医生的期望标准。本文回顾了主要研究结果，并就改善高血压患者的服药情况提出建议。它总结了几项与高血压流行病学、导致降压药物依从性欠佳的相关行为、不依从行为的直接和间接成本以及服药行为测量方法有关的研究。基于这一分析，目前高血压的检测、治疗和控制水平仍不理想。调整抗高血压治疗方案的经验法则可能会产生误导且过于简单。在未达到血压目标的患者中，超过一半表现出服药依从性欠佳，而非治疗方案不足。总之，需要提高对服药行为的认识，尤其是针对高血压患者，以便更多此类患者能够充分受益于有效治疗。
