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以患者为中心的初级保健与患者高血压药物治疗依从性相关。

Patient centered primary care is associated with patient hypertension medication adherence.

机构信息

VA Tennessee Valley Healthcare, Tennessee Valley Geriatric Research Education Clinical Center (GRECC), Nashville, TN 37212, USA.

出版信息

J Behav Med. 2011 Aug;34(4):244-53. doi: 10.1007/s10865-010-9304-6. Epub 2010 Dec 16.

Abstract

There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.

摘要

越来越多的证据表明,以患者为中心的护理,包括沟通技巧,是慢性病护理的重要组成部分。我们的目的是评估以患者为中心的初级保健作为药物依从性的决定因素。我们向 1341 名患有高血压的退伍军人邮寄了简短的初级保健评估调查(PCAS),该调查衡量了以患者为中心的初级保健的要素。我们前瞻性地收集了每位患者 6 个月的降压药物依从性。如果患者的药物使用率>80%,则认为其依从性高。共收回 654 份调查问卷(50.7%);并对 499 名数据完整的患者进行了分析。以患者为中心的护理评分越高,降压药物的依从性也越高[RR 3.18(95% CI 1.44,16.23)bootstrap 5000 次重复],PCAS 评分为 4.5(最高四分位数)与 1.5(最低四分位数)相比。需要进一步研究以确定改善以患者为中心的护理,特别是沟通技巧,是否可以改善与健康相关的行为,如药物依从性和健康结果。

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