Jokisalo E, Kumpusalo E, Enlund H, Halonen P, Takala J
Department of Social Pharmacy, University of Kuopio, Finland.
J Hum Hypertens. 2002 Aug;16(8):577-83. doi: 10.1038/sj.jhh.1001448.
The objectives were to study the associations of perceived health care-related and patient-related factors with self-reported noncompliance with antihypertensive treatment. General practitioners identified all of their hypertensive patients in 26 health centres during 1 week in 1996 (n = 2219). A total of 1782 (80%) patients participated in the study, of whom 1561 were on antihypertensive medication. Based on 82 opinion statements in two questionnaires, 14 problem indices were formed by using factor analysis. Out of these, summary variables concerning problems related to the health care system and the patients were formed. Logistic regression models, including interaction analyses, were used to study the associations with non-compliance. The results were that the majority of patients had at least one perceived health care system-related (88%) and patient-related problem (92%). A high number of both perceived health care system-related problems (adjusted OR 4.77; 95% CI 2.76, 8.26) and patient-related problems (adjusted OR 3.23; 95% CI 1.79, 5.81) were associated with self-reported non-compliance. The experience of adverse drug effects was also associated with non-compliance (adjusted OR 1.41; 95% CI 1.03, 1.94). In conclusion self-reported non-compliance was associated with multiple risks of both perceived health care system-related and patient-related problems.
研究目的是探讨感知到的医疗保健相关因素和患者相关因素与自我报告的抗高血压治疗不依从性之间的关联。1996年,全科医生在1周内识别出26个健康中心的所有高血压患者(n = 2219)。共有1782名(80%)患者参与了研究,其中1561名正在接受抗高血压药物治疗。基于两份问卷中的82条意见陈述,通过因子分析形成了14个问题指数。在此基础上,形成了与医疗保健系统和患者相关问题的汇总变量。使用逻辑回归模型(包括交互分析)来研究与不依从性的关联。结果显示,大多数患者至少有一个感知到的与医疗保健系统相关的问题(88%)和与患者相关的问题(92%)。大量感知到的与医疗保健系统相关的问题(调整后的比值比为4.77;95%可信区间为2.76, 8.26)和与患者相关的问题(调整后的比值比为3.23;95%可信区间为1.79, 5.81)都与自我报告的不依从性相关。药物不良反应的经历也与不依从性相关(调整后的比值比为1.41;95%可信区间为1.03, 1.94)。总之,自我报告的不依从性与感知到的医疗保健系统相关和患者相关问题的多种风险相关。