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前苏联不规则的高血压治疗方法。

Irregular treatment of hypertension in the former Soviet Union.

机构信息

European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.

出版信息

J Epidemiol Community Health. 2012 Jun;66(6):482-8. doi: 10.1136/jech.2010.111377. Epub 2010 Nov 4.

Abstract

BACKGROUND

The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment.

AIMS

To describe the regularity of treatment among those diagnosed with hypertension and prescribed treatment in eight countries of the former Soviet Union, and explore which factors are associated with not taking medication regularly.

METHODS

Using data from over 18 000 respondents from eight former Soviet countries, individuals who had been told that they had hypertension by a health professional and prescribed treatment were identified. By means of multivariate logistic analysis the characteristics of those taking treatment daily and less than daily were compared.

RESULTS

Only 26% of those prescribed treatment took it daily. The probability of doing so varied among countries and was highest in Russia, Belarus and Georgia, and lowest in Armenia (although Georgia's apparent advantage may reflect low rates of diagnosis). Women, older people, those living in urban areas, and non-smokers and non-drinkers were more likely to take treatment daily.

CONCLUSIONS

A high proportion of those who have been identified by health professionals as requiring hypertension treatment are not taking it daily. These findings suggest that irregular hypertension treatment is a major problem in this region and will require an urgent response.

摘要

背景

苏联未能建立起现代制药业,也缺乏可靠的药品分发能力。患者需要支付门诊药品费用,而继承苏联的各后续国家也延续了这一传统,因此需要长期治疗的患者面临着相当大的获取治疗的障碍。有人假设,需要接受高血压治疗的前苏联共和国的公民可能无法定期接受治疗。

目的

描述在前苏联八个国家中,被诊断患有高血压并接受治疗的患者的治疗规律,并探讨哪些因素与不规律服药有关。

方法

利用来自前苏联八个国家的 18000 多名受访者的数据,确定了那些被医疗保健专业人员告知患有高血压并开了处方的患者。通过多变量逻辑分析,比较了每天和每天少于一次服用药物的患者的特征。

结果

只有 26%的开了处方的患者每天服用药物。这种情况在各国之间存在差异,在俄罗斯、白俄罗斯和格鲁吉亚最高,而在亚美尼亚最低(尽管格鲁吉亚的明显优势可能反映了低诊断率)。女性、老年人、居住在城市地区的人、不吸烟和不饮酒的人更有可能每天服用药物。

结论

很大一部分被医疗保健专业人员确定需要高血压治疗的患者并未每天服用药物。这些发现表明,不规则的高血压治疗是该地区的一个主要问题,需要紧急应对。

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