老年人抑郁与抗高血压药物依从性的关系：CoSMO 的横断面和纵向研究结果。
Association of depression with antihypertensive medication adherence in older adults: cross-sectional and longitudinal findings from CoSMO.
机构信息
Center for Health Research, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA.
出版信息
Ann Behav Med. 2010 Dec;40(3):248-57. doi: 10.1007/s12160-010-9217-1.
BACKGROUND
Little is known about the associations between depressive symptoms, social support and antihypertensive medication adherence in older adults.
PURPOSE
We evaluated the cross-sectional and longitudinal associations between depressive symptoms, social support and antihypertensive medication adherence in a large cohort of older adults.
METHODS
A cohort of 2,180 older adults with hypertension was administered questionnaires, which included the Center for Epidemiologic Studies-Depression Scale, the Medical Outcomes Study Social Support Index, and the hypertension-specific Morisky Medication Adherence Scale at baseline and 1 year later.
RESULTS
Overall, 14.1% of participants had low medication adherence, 13.0% had depressive symptoms, and 33.9% had low social support. After multivariable adjustment, the odds ratios that participants with depressive symptoms and low social support would have low medication adherence were 1.96 (95% confidence interval (CI) 1.43, 2.70) and 1.27 (95% CI 0.98, 1.65), respectively, at baseline and 1.87 (95% CI 1.32, 2.66) and 1.30 (95% CI 0.98, 1.72), respectively, at 1 year follow-up.
CONCLUSION
Depressive symptoms may be an important modifiable barrier to antihypertensive medication adherence in older adults.
背景
老年人的抑郁症状、社会支持与降压药物治疗依从性之间的关联知之甚少。
目的
我们评估了在一个大型老年人群中，抑郁症状、社会支持与降压药物治疗依从性之间的横断面和纵向关联。
方法
在基线和 1 年后，对 2180 名高血压老年患者进行问卷调查，问卷包括流行病学研究中心抑郁量表、医疗结局研究社会支持指数和高血压特异性 Morisky 药物依从性量表。
结果
总体而言，14.1%的参与者药物治疗依从性低，13.0%的参与者有抑郁症状，33.9%的参与者社会支持低。经过多变量调整，基线时患有抑郁症状和社会支持低的参与者药物治疗依从性低的比值比（OR）分别为 1.96（95%置信区间（CI）1.43，2.70）和 1.27（95%CI 0.98，1.65），1 年随访时的 OR 分别为 1.87（95%CI 1.32，2.66）和 1.30（95%CI 0.98，1.72）。
结论
抑郁症状可能是老年人降压药物治疗依从性的一个重要可改变的障碍。
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