Wai Kuinileti Chang, Elley C Raina, Nosa Vili, Kennelly John, Mabotuwana Thusitha, Warren Jim
Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, PB 92019, Auckland, New Zealand.
J Prim Health Care. 2010 Sep 1;2(3):217-24.
To explore influences on adherence to taking long-term medications among Samoan patients in an Auckland general practice.
Twenty Samoan participants from an Auckland general practice were identified and interviewed about their views on adherence or non-adherence to taking blood pressure-lowering medications. One-to-one semi-structured interviews using open-ended questions were undertaken in Samoan and English, recorded, transcribed and translated into English. Transcriptions were examined by two researchers to identify themes.
Patients with 'high' and 'lower' rates of adherence to taking usual medication were identified using medication possession ratio cut-offs from medical records of timely prescribing. Ten participants with 'high' and 10 with 'lower' rates of adherence were interviewed, including 11 women and nine men. Themes identified for those with lower adherence included 'lack of transport', 'family commitments', 'forgetfulness', 'church activities', 'feeling well' and 'priorities'. Themes identified for those with high rates of adherence included 'prioritising health', 'previous event', 'time management', 'supportive family members' and 'relationship with GP (language and trust)'. A theme common to both was 'coping with the stress of multiple comorbidities'.
Reasons for adherence and non-adherence to taking blood pressure-lowering medications among the Samoan patients interviewed were multifactorial and encompass personal, social, cultural and environmental factors. Interdisciplinary teams to support treatment decisions (including Pacific health professionals or community health workers), systematic identification of those with low rates of adherence, phone or text follow-up, use of church or family networks, provision of transport where needed and better tools and resources may help address this problem.
探讨奥克兰一家全科诊所中萨摩亚患者长期服药依从性的影响因素。
从奥克兰一家全科诊所中挑选出20名萨摩亚参与者，就他们对服用降压药依从性或不依从性的看法进行访谈。采用开放式问题进行一对一的半结构化访谈，分别用萨摩亚语和英语进行，录音、转录并翻译成英语。两名研究人员对转录内容进行检查以确定主题。
利用及时开药的病历中的药物持有率临界值，确定了常规药物服用依从性“高”和“低”的患者。对10名依从性“高”的参与者和10名依从性“低”的参与者进行了访谈，其中包括11名女性和9名男性。确定的依从性较低者的主题包括“交通不便”“家庭事务”“健忘”“教会活动”“感觉良好”和“优先事项”。确定的依从性较高者的主题包括“将健康放在首位”“既往事件”“时间管理”“支持性的家庭成员”以及“与全科医生的关系（语言和信任）”。两者共有的一个主题是“应对多种合并症的压力”。
接受访谈的萨摩亚患者服用降压药依从或不依从的原因是多方面的，包括个人、社会、文化和环境因素。支持治疗决策的跨学科团队（包括太平洋卫生专业人员或社区卫生工作者）、系统识别依从性低的患者、电话或短信随访、利用教会或家庭网络、在需要时提供交通以及更好的工具和资源可能有助于解决这一问题。
