School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, New Territories, Hong Kong.
Clin Res Cardiol. 2010 May;99(5):277-84. doi: 10.1007/s00392-010-0114-1. Epub 2010 Feb 21.
This cohort study evaluated the factors associated with discontinuation of antihypertensive pharmacotherapy among Chinese patients who were prescribed beta-blockers. We tested the hypothesis that patients' age, gender, socioeconomic status, clinical settings and the number of comorbidities were significantly associated with the discontinuation of beta-blockers.
From a validated clinical database we included all adult patients 18 years or older who were prescribed a beta-blocker in any government primary care clinic in one large territory of Hong Kong during 01 January 2004-30 June 2007. We evaluated the cumulative incidence of drug discontinuation within 180 days of the prescriptions and the factors associated with discontinuation of beta-blockers by multivariable regression analysis.
From a total of 19,177 eligible patients (mean age = 59.1 years), 20.8% discontinued their medication. Younger patients [aged <50 years; adjusted odds ratios (aOR) 0.41-0.52 for patients aged >or=50 years; p < 0.001], female gender (aOR 0.87 for males, p = 0.001), fee-waivers (aOR 0.78 for fee-payers, p < 0.001), attendances in family medicine specialist clinics (FMSC) (aOR 1.49, p < 0.001) and staff clinics (aOR 2.32, p < 0.001), residence in more urbanized areas (aOR 0.80 for North District, p < 0.001), new visits (aOR 0.55 for follow-up visits, p < 0.001) and absence of concomitant comorbidities (aOR 0.60 for one comorbidity, p < 0.001; aOR 0.56 for two comorbidities, p = 0.002) were positively associated with drug discontinuation.
Patients who were prescribed beta-blockers with these associated factors should be monitored more closely for antihypertensive drug adherence.
本队列研究评估了中国接受β受体阻滞剂治疗的高血压患者停药相关因素。我们检验了以下假设，即患者年龄、性别、社会经济地位、临床科室和共病数量与β受体阻滞剂的停药显著相关。
从一个经过验证的临床数据库中，我们纳入了 2004 年 1 月 1 日至 2007 年 6 月 30 日期间在香港一个大区的任何政府基层医疗诊所接受β受体阻滞剂治疗的所有 18 岁及以上的成年患者。我们通过多变量回归分析评估了处方后 180 天内药物停药的累积发生率和与β受体阻滞剂停药相关的因素。
在总共 19177 名合格患者中（平均年龄 59.1 岁），有 20.8%的患者停止了药物治疗。年轻患者（年龄<50 岁；年龄≥50 岁患者的调整比值比[aOR]为 0.41-0.52；p<0.001）、女性（男性患者的 aOR 为 0.87，p=0.001）、免费用药（自费患者的 aOR 为 0.78，p<0.001）、家庭医学专科诊所（FMSC）就诊（aOR 为 1.49，p<0.001）和职员诊所就诊（aOR 为 2.32，p<0.001）、居住在更城市化地区（北区患者的 aOR 为 0.80，p<0.001）、初诊（复诊患者的 aOR 为 0.55，p<0.001）和无共病（一种共病患者的 aOR 为 0.60，p<0.001；两种共病患者的 aOR 为 0.56，p=0.002）与药物停药呈正相关。
接受β受体阻滞剂治疗的患者存在这些相关因素时，应更密切地监测其降压药物的依从性。
