College of Nursing, University of Arizona, PO 210203, Tucson, AZ 85721, USA.
Contemp Clin Trials. 2013 Jan;34(1):45-52. doi: 10.1016/j.cct.2012.09.005. Epub 2012 Sep 23.
Adherence to prescribed antihypertensive agents is critical because control of elevated blood pressure is the single most important way to prevent stroke and other end organ damage. Unfortunately, nonadherence remains a significant problem. Previous interventions designed to improve adherence have demonstrated only small benefits of strategies that target single facets such as understanding medication directions. The intervention described here is informed by prospective memory theory and performance of older adults in laboratory-based paradigms and uses a comprehensive, multifaceted approach to improve adherence. It incorporates multiple strategies designed to support key components of prospective remembering involved in taking medication. The intervention is delivered by nurses in the home with an education control group for comparison. Differences between groups in overall adherence following the intervention and 6 months later will be tested. Systolic and diastolic blood pressure levels also will be examined between groups and as they relate to adherence. Intra-individual regression is planned to examine change in adherence over time and its predictors. Finally, we will examine the association between executive function/working memory and adherence, predicting that adherence will be related to executive/working memory in the control group but not in the intervention group.
坚持服用规定的降压药是至关重要的，因为控制血压升高是预防中风和其他靶器官损害的唯一最重要方法。不幸的是，不遵医嘱仍然是一个严重的问题。以前旨在提高依从性的干预措施仅显示出针对单一方面（如理解药物说明）的策略的微小益处。这里描述的干预措施是基于前瞻性记忆理论和老年人在实验室范式中的表现，并采用全面的、多方面的方法来提高依从性。它结合了多种策略，旨在支持与服用药物相关的前瞻性记忆的关键组成部分。该干预措施由家庭护士提供，并设立教育对照组进行比较。将在干预后和 6 个月后测试组间整体依从性的差异。还将在组间检查收缩压和舒张压水平，并研究其与依从性的关系。计划进行个体内回归，以检查随时间推移的依从性变化及其预测因素。最后，我们将检查执行功能/工作记忆与依从性之间的关系，预测在对照组中，依从性与执行/工作记忆有关，但在干预组中则无关。
