Cramer J A
Yale--VA Medical Center, West Haven, CT 06516, USA.
Am J Manag Care. 1998 Nov;4(11):1563-8.
To review patient compliance with once-daily antihypertensive medications and the impact of partial compliance on healthcare outcomes.
A MEDLINE search of the literature using the terms "patient compliance," "antihypertensive medications," and "hypertension" for the period 1976-1996 was conducted. In addition, papers cited in reference lists of source articles were reviewed.
Articles were selected if they described patterns of compliance, including rates for differing dosing regimens. Articles discussing once-daily dosing were selected only if they included information on the methodology for compliance assessment. Thirteen reports met these criteria.
Patterns of compliance vary, with only a partial relationship to dosing regimens. Overall compliance was 76% for once-daily antihypertensive medications, with a wide range found (53% to 85%). These data were comparable to the mean 75% compliance found for other medical disorders.
Persistence with treatment is necessary for reduction of long-term consequences of hypertension. Enhancing compliance with antihypertensive medications could thus have a profound impact on health outcomes. Once-daily dosing should be coupled with selection of a drug with long duration of action to overcome problems of missed doses. Widespread adoption of simple compliance enhancement methods could lead to decreased morbidity and mortality from cardiovascular disease and stroke.
回顾患者对每日一次降压药物的依从性以及部分依从性对医疗结果的影响。
利用“患者依从性”“降压药物”和“高血压”等术语对1976年至1996年期间的文献进行了MEDLINE检索。此外，还对原始文章参考文献列表中引用的论文进行了审查。
如果文章描述了依从性模式，包括不同给药方案的比率，则予以选择。只有当讨论每日一次给药的文章包含依从性评估方法的信息时才会被选中。有13篇报告符合这些标准。
依从性模式各不相同，与给药方案只有部分关联。每日一次降压药物的总体依从性为76%，发现范围很广（53%至85%）。这些数据与其他疾病的平均75%的依从性相当。
坚持治疗对于降低高血压的长期后果是必要的。因此，提高对降压药物的依从性可能会对健康结果产生深远影响。每日一次给药应与选择作用持续时间长的药物相结合，以克服漏服药物的问题。广泛采用简单的依从性增强方法可能会降低心血管疾病和中风的发病率和死亡率。
