Islam Tareq, Muntner Paul, Webber Larry S, Morisky Don E, Krousel-Wood Marie A
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Am J Med Sci. 2008 Aug;336(2):105-10. doi: 10.1097/MAJ.0b013e318180f175.
Previous research indicates that many patients with hypertension ran out of medications and had difficulties getting refills immediately after Hurricane Katrina. The extended effect of Hurricane Katrina on antihypertensive medication adherence is not well characterized.
Data were analyzed for 2194 participants who completed the baseline survey for the Cohort Study of Medication Adherence among Older Adults between August 2006 and September 2007. Based on pre-Katrina zip codes, the study population was categorized into high- and low-affected areas. Low medication adherence was defined as a score less than 6 on the 8-item Morisky Medication Adherence Scale.
Prevalence of low adherence was similar among participants living in high and low affected areas. Low medication adherence was similar for participants with greater than or less than 25% of the residence damaged by Hurricane Katrina and for participants with and without symptoms of post-traumatic stress disorder. In high affected areas, nonsignificant associations were present for those who had moved since the storm and those with a friend or immediate family member who had died in the month after the storm. These factors were not associated with low medication adherence in low affected areas. In both high- and low-affected areas, lower scores on the hurricane coping self-efficacy scale were associated with low medication adherence (P < 0.05).
The effect of Hurricane Katrina on patient adherence to antihypertensive medication was limited in the second year after the storm. Intrinsic patient factors, such as low coping self-efficacy, remain important factors associated with low adherence.
先前的研究表明,许多高血压患者在卡特里娜飓风过后药物用完,且难以立即获得续方。卡特里娜飓风对降压药依从性的长期影响尚未得到充分描述。
对2006年8月至2007年9月期间完成老年人药物依从性队列研究基线调查的2194名参与者的数据进行了分析。根据卡特里娜飓风来袭前的邮政编码,将研究人群分为高影响区和低影响区。低药物依从性定义为在8项Morisky药物依从性量表上得分低于6分。
高影响区和低影响区的参与者中低依从性的患病率相似。卡特里娜飓风造成居住房屋损坏超过或低于25%的参与者以及有或没有创伤后应激障碍症状的参与者,其药物低依从性情况相似。在高影响区,自风暴过后搬离的人以及在风暴过后一个月内有朋友或直系亲属死亡的人与低药物依从性存在不显著的关联。在低影响区,这些因素与低药物依从性无关。在高影响区和低影响区,飓风应对自我效能量表得分较低都与低药物依从性相关(P<0.05)。
卡特里娜飓风过后第二年,其对患者降压药依从性的影响有限。患者的内在因素,如应对自我效能低下,仍然是与低依从性相关的重要因素。