Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul, South Korea.
Eur J Cardiovasc Nurs. 2013 Feb;12(1):17-24. doi: 10.1016/j.ejcnurse.2011.05.006. Epub 2012 Mar 5.
Adherence to a medication regimen is a major factor in achieving adequate blood pressure control for hypertensive patients. However, older adults often report having missed doses, which they attribute to forgetfulness. The purpose of this study was to identify significant factors, including socioeconomic variables, hypertension history, and cognitive functions, contributing to medication adherence among older Korean adults with hypertension.
This study involved 241 older patients with hypertension from a community senior center during the period from 2008 to 2009. Data were collected through face to face interviews. The association of medication adherence with socioeconomic characteristics, hypertension-related history, knowledge, antihypertensive lifestyle, and memory was assessed by computing odds ratios in logistic regressions.
Of the 241 patients, 44% were aged 75 or older, and 60% were male. The rate of non-adherence with antihypertensive medication was 41%. Metamemory, adherence to an antihypertensive lifestyle, and employment status, were associated with participants' adherence to antihypertensive medication in both univariate and multivariate analyses. Results suggest that memory functions are a key factor to medication adherence among the Korean elderly population. In contrast to younger adults, unintentional non-adherence appears to be a major issue for older adults to keep medicating. Interventions focusing on memory ability, such as strategies for recalling and placing cues, are needed for implementation in the population of older Korean patients with hypertension. Unemployed older people who have hypertensive lifestyles should also be considered a high-risk group for non-adherence to medication.
遵医嘱服药是高血压患者实现充分血压控制的一个主要因素。然而,老年人经常报告忘记服药,他们将其归因于健忘。本研究的目的是确定与药物依从性相关的重要因素,包括社会经济变量、高血压病史和认知功能,这些因素可能导致韩国老年高血压患者的药物依从性降低。
本研究于 2008 年至 2009 年期间,选取了来自社区老年人中心的 241 名老年高血压患者。通过面对面访谈收集数据。采用逻辑回归计算比值比,评估药物依从性与社会经济特征、高血压相关病史、知识、降压生活方式和记忆力之间的关联。
在 241 名患者中,44%年龄在 75 岁或以上,60%为男性。抗高血压药物不依从的比例为 41%。元记忆、遵守抗高血压生活方式和就业状况,在单因素和多因素分析中均与参与者的抗高血压药物依从性相关。结果表明,记忆功能是韩国老年人群药物依从性的关键因素。与年轻成年人不同,非故意不依从似乎是老年成年人坚持服药的一个主要问题。需要针对记忆能力实施干预措施,例如回忆和放置提示的策略,以应用于高血压的韩国老年患者人群。有高血压生活方式的失业老年人也应被视为药物不依从的高风险群体。