Duke University School of Nursing, Durham NC 27710, USA.
J Clin Nurs. 2012 May;21(9-10):1401-6. doi: 10.1111/j.1365-2702.2011.03859.x. Epub 2011 Nov 23.
We sought to identify the feasibility and predictive validity of an easy and quick self-reported measure of medication adherence and to identify characteristics of people with hypertension that may warrant increase attentiveness by nurses to address hypertensive self-management needs.
Current control rates of hypertension are approximately 50%. Effective blood pressure control can be achieved in most people with hypertension through antihypertensive medication. However, hypertension control can only be achieved if the patient is adherent with their medication regimen. Patients who are non-adherent may be in need of additional intervention.
This secondary analysis evaluated the systolic blood pressure of patients who received usual hypertension management across 24 months at six-month intervals.
A longitudinal study of 159 hypertensive patients in two primary care clinics.
In a sample of 159 patients receiving care in a primary care facility, baseline medication non-adherence was associated with a 6·3 mmHg increase in systolic blood pressure (p < 0·05) at baseline, a 8·4 mmHg increase in systolic blood pressure (p < 0·05) at 12 months and a 7·5 increase in systolic blood pressure at 24 months (p < 0·05) compared with adherent patients, respectively. Results also indicate a significant increase in systolic blood pressure across 24 months among people who identified as minority and of low financial status.
Non-adherence with antihypertensive medication at baseline was predictive of increased systolic blood pressure up to 24 months postbaseline.
This study demonstrates the use of an easy-to-use questionnaire to identify patients who are non-adherent. We recommend assessing medication adherence to identify patients who are non-adherent with their anti-hypertensive medication and to be especially vigilant with patients who are minority or are considered low income.
我们旨在确定一种简单、快速的自我报告药物依从性测量方法的可行性和预测有效性，并确定高血压患者的特征，这些特征可能需要护士更加关注，以满足高血压自我管理的需求。
目前高血压的控制率约为 50%。通过抗高血压药物，大多数高血压患者可以有效地控制血压。然而，只有患者坚持服用药物，才能控制高血压。不依从药物治疗的患者可能需要额外的干预。
本二次分析评估了在 24 个月的 6 个月间隔内接受常规高血压管理的患者的收缩压。
对两家初级保健诊所的 159 例高血压患者进行了一项纵向研究。
在一个在初级保健机构接受治疗的 159 例患者样本中，基线药物不依从与收缩压基线时升高 6.3mmHg（p<0.05）、12 个月时升高 8.4mmHg（p<0.05）和 24 个月时升高 7.5mmHg（p<0.05）相关，与依从性患者相比。结果还表明，在 24 个月期间，少数民族和经济状况较差的人群的收缩压显著升高。
基线时抗高血压药物不依从与基线后 24 个月内收缩压升高相关。
本研究展示了使用简单易用的问卷来识别不依从的患者。我们建议评估药物依从性，以确定不依从抗高血压药物的患者，并对少数民族或被认为收入较低的患者特别警惕。
