台湾高血压患者药物治疗不依从性的相关因素。

Factors related to medication non-adherence for patients with hypertension in Taiwan.

作者信息

Li Wen-Wen, Kuo Chi-Tai, Hwang Shiow-Li, Hsu Hsin-Tien

机构信息

School of Nursing, San Francisco State University, San Francisco, CA, USA.

出版信息

J Clin Nurs. 2012 Jul;21(13-14):1816-24. doi: 10.1111/j.1365-2702.2012.04088.x.

DOI:10.1111/j.1365-2702.2012.04088.x

PMID:22672451

Abstract

AIMS AND OBJECTIVE

To characterise a Taiwanese population and to examine the prevalence of antihypertensive medication non-adherence and how the cultural/clinical factors were associated with non-adherence in Taiwan.

BACKGROUND

Antihypertensive medication non-adherence is a significant clinical issue in the United States. However, little is known about hypertension (HTN) control and cultural/clinical factors related to non-adherence in Taiwan.

DESIGN

A convenience sample survey design was used.

METHOD

Data were gathered from a convenience sample of 200 subjects recruited from a large teaching hospital. Medication non-adherence and cultural/clinical factors were recorded using various self-administered questionnaires, and blood pressure was taken twice for each participant.

RESULTS

The mean age of the participants was 60.4 (SD 11.5 years) including 62% men. Two-thirds had less than a high school education (64.5%), and the majority of them were married (86·0%) and lived with family or close friends (93.5%). The average length of HTN diagnosis was 8.6 years (SD 9.0 years). Medication non-adherence rate was 47·5%, and uncontrolled HTN rate was 49.0%. Some participants (17.0%) used Chinese herbs for treating their disease (e.g. cough) and promoting health in addition to their regular antihypertensive medications. Two factors were found to be statistically significant for predicting medication non-adherence: Lower Perceived Susceptibility to Specific Diseases [OR = 1.15 (95%CI, 1.01-1.31)] and Longer Length of HTN Diagnosis [OR = 1.06 (95%CI, 1.01-1.12)].

CONCLUSIONS

Taiwanese at risk of non-adherence included those who perceived lower susceptibility to specific diseases and had been diagnosed with HTN for a longer time. Those using herbs need to be studied for an impact of herbs on their adherence behaviour.

RELEVANCE TO CLINICAL PRACTICE

These findings can help guide the development of culturally sensitive and clinically appropriate nursing interventions for HTN management in Taiwan.

摘要

目的

对台湾人群进行特征描述，调查抗高血压药物治疗依从性不佳的患病率，以及文化/临床因素与台湾地区治疗依从性不佳之间的关联。

背景

在美国，抗高血压药物治疗依从性不佳是一个重要的临床问题。然而，对于台湾地区高血压（HTN）控制情况以及与治疗依从性不佳相关的文化/临床因素，人们知之甚少。

设计

采用便利抽样调查设计。

方法

数据来自于从一家大型教学医院招募的200名受试者的便利样本。使用各种自填问卷记录药物治疗依从性不佳情况和文化/临床因素，并为每位参与者测量两次血压。

结果

参与者的平均年龄为60.4岁（标准差11.5岁），其中男性占62%。三分之二的人受教育程度低于高中（64.5%），他们中的大多数已婚（86.0%），与家人或亲密朋友住在一起（93.5%）。高血压诊断的平均时长为8.6年（标准差9.0年）。药物治疗依从性不佳率为47.5%，高血压未得到控制的比率为49.0%。一些参与者（17.0%）除了常规抗高血压药物外，还使用中药治疗疾病（如咳嗽）和促进健康。发现有两个因素在预测药物治疗依从性不佳方面具有统计学意义：对特定疾病的感知易感性较低[比值比（OR）=1.15（95%置信区间，1.01 - 1.31）]和高血压诊断时长较长[OR = 1.06（95%置信区间，1.01 - 1.12）]。