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残疾人和非残疾人在抗高血压药物依从性方面的差异:一项基于韩国人群的研究结果。

Disparities in antihypertensive medication adherence in persons with disabilities and without disabilities: results of a Korean population-based study.

作者信息

Park Jong Hyock, Park Jae Hyun, Lee Sang Yi, Kim So Young, Shin Youngsoo, Kim Su Young

机构信息

Cancer Policy and Management Branch, National Cancer Center, Cheju, Korea.

出版信息

Arch Phys Med Rehabil. 2008 Aug;89(8):1460-7. doi: 10.1016/j.apmr.2007.12.045.

Abstract

OBJECTIVE

To determine disparities in antihypertensive medication adherence between persons with disabilities and those without disabilities in South Korea.

DESIGN

The study compared antihypertensive medication adherence between persons with disabilities and those without disabilities using medical claims data of the National Health Insurance (NHI).

SETTING

We obtained data from claims submitted to the NHI, which covers almost the entire Korean population. Persons who were prescribed antihypertensive medication during the calendar year 2004 were identified.

PARTICIPANTS

The study comprised data from persons with disabilities (n=85,098) and persons without disabilities (n=2,368,636).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

A cumulative medication adherence (CMA) greater than or equal to 80% was defined as an appropriate medication adherence. Multiple logistic regression was used to identify differences in antihypertensive medication adherence between persons with disabilities and without disabilities. Estimates were adjusted for demographic characteristics (sex, age), type of medical insurance, insurance contribution a month as a proxy for household income, residential area, and clinical characteristics (medication duration, comorbid conditions).

RESULTS

People with disabilities had lower CMAs than those without (median CMA, 83.6% vs 85.7%; appropriate medication adherence, 54.5% vs 57.5%). Results of the multiple logistic regression adjusting other factors indicated that people with disabilities had decreased probabilities of appropriate adherence.

CONCLUSIONS

Medication adherence is reduced by various types of disability and impairment such as those involving mobility and communication. Much effort should be made to investigate how and why these disparities take place and develop health policies to remove these disparities if they exist.

摘要

目的

确定韩国残疾人和非残疾人在抗高血压药物依从性方面的差异。

设计

本研究使用国民健康保险(NHI)的医疗理赔数据,比较了残疾人和非残疾人的抗高血压药物依从性。

设置

我们从提交给NHI的理赔数据中获取信息,该数据覆盖了几乎全体韩国人口。确定了在2004日历年期间开具抗高血压药物处方的人员。

参与者

该研究包括来自残疾人(n = 85,098)和非残疾人(n = 2,368,636)的数据。

干预措施

不适用。

主要观察指标

累积药物依从性(CMA)大于或等于80%被定义为适当的药物依从性。采用多元逻辑回归来确定残疾人和非残疾人在抗高血压药物依从性方面的差异。估计值针对人口统计学特征(性别、年龄)、医疗保险类型、作为家庭收入代理指标的月保险费、居住地区和临床特征(用药持续时间、合并症)进行了调整。

结果

残疾人的CMA低于非残疾人(中位CMA,83.6%对85.7%;适当药物依从性,54.5%对57.5%)。调整其他因素后的多元逻辑回归结果表明,残疾人适当依从的概率降低。

结论

各种类型的残疾和损伤,如涉及行动和沟通的残疾和损伤,会降低药物依从性。应付出很大努力来调查这些差异如何以及为何发生,并制定卫生政策以消除这些差异(如果存在的话)。

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