Division of Preventative Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-4410, USA.
Am J Health Promot. 2011 Jul-Aug;25(6):372-8. doi: 10.4278/ajhp.090123-QUAN-26.
Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults.
Randomized controlled trial.
Rural south Alabama.
Low-income adults (N = 434) receiving medication at no charge from a public health department or a Federally Qualified Health Center.
Both interventions were home-based and delivered via computer by a community health advisor. The adherence promotion (AP) intervention focused on theoretical variables related to adherence (e.g., barriers, decisional balance, and role models). The cancer control condition received general cancer information.
Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey.
Chi-square analysis tested the hypothesis that a greater proportion of participants in the AP intervention are ≥80% adherent compared to the control group. General linear modeling examined adherence as a continuous variable.
Participants receiving the intervention did not differ from individuals in the control group (51% vs. 49% adherent, respectively; p = .67). Clinic type predicted adherence (p < .0001), as did forgetting to take medications (p = .01) and difficulty getting to the clinic to obtain medications (p < .001).
Multilevel interventions that focus on individual behavior and community-level targets (e.g., how health care is accessed and delivered) may be needed to improve medication adherence among low-income rural residents.
研究基于社区的多媒体干预对高血压成年患者药物依从性的影响。
随机对照试验。
阿拉巴马州南部农村。
从公共卫生部门或合格的联邦健康中心免费领取药物的低收入成年人（N=434）。
两种干预均为家庭式干预，由社区健康顾问通过计算机进行。遵医用药促进（AP）干预侧重于与遵医行为相关的理论变量（例如，障碍、决策平衡和榜样）。癌症控制组则接受一般的癌症信息。
通过药物计数评估遵医程度。通过电话调查收集其他与遵医行为相关的变量，包括障碍、自我效能、抑郁和社会人口统计学变量。
卡方检验检验了 AP 干预组中≥80%的参与者比对照组更能遵医的假设。线性模型检验了作为连续变量的遵医行为。
接受干预的参与者与对照组的参与者没有差异（分别为 51%和 49%的参与者遵医，p=0.67）。诊所类型预测了遵医行为（p<0.0001），忘记服药（p=0.01）和难以去诊所取药（p<0.001）也是如此。
可能需要针对个人行为和社区级目标（例如，医疗保健的获取和提供方式）的多层次干预措施，以提高农村低收入居民的药物依从性。
