Cheng J W, Kalis M M, Feifer S
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Broklyn, New York 11201, USA.
Pharmacotherapy. 2001 Jul;21(7):828-41. doi: 10.1592/phco.21.9.828.34557.
To compare antihypertensive drug compliance with treatment guidelines established by the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), and to identify patient adherence to antihypertensive drugs and factors affecting prescribing patterns.
Patients filling antihypertensive drug prescriptions in metropolitan New York area pharmacies were enrolled. Pharmacy externs collected patient-reported demographics, medical and drug histories, and blood pressure measurements. Compliance with JNC VI guidelines was assessed.
Eight hundred twenty-one patients from 102 pharmacies participated. Blood pressure was controlled in 61% of patients at the time of the study. The most prescribed class of antihypertensive agents was angiotensin-converting enzyme inhibitors, followed by diuretics and beta-blockers. Over the study period, compliance with JNC VI guidelines decreased significantly from 85% to 64% (p<0.05). Thirty-seven percent of patients reported consistent adherence to their antihypertensive regimens. Patients' education level was the only factor found to correlate positively with the appropriateness of antihypertensive agents prescribed.
Compliance with JNC VI guidelines decreased over time, and patient adherence to drug therapy was suboptimal. Continuing-education efforts to reinforce optimal blood pressure management are necessary.
比较抗高血压药物依从性与第六届全国高血压预防、检测、评估与治疗联合委员会（JNC VI）制定的治疗指南，并确定患者对抗高血压药物的依从性以及影响处方模式的因素。
纳入在纽约市大都市区药房填写抗高血压药物处方的患者。药房实习生收集患者报告的人口统计学信息、病史和用药史以及血压测量值。评估对JNC VI指南的依从性。
来自102家药房的821名患者参与研究。在研究时，61%的患者血压得到控制。最常开具的抗高血压药物类别是血管紧张素转换酶抑制剂，其次是利尿剂和β受体阻滞剂。在研究期间，对JNC VI指南的依从性从85%显著降至64%（p<0.05）。37%的患者报告持续依从其抗高血压治疗方案。发现患者的教育水平是唯一与所开抗高血压药物的适宜性呈正相关的因素。
随着时间推移，对JNC VI指南的依从性降低，患者对药物治疗的依从性欠佳。有必要开展继续教育以加强最佳血压管理。
