Santé Communautaire, University of Sherbrook, Longueuil, Quebec, Canada.
J Am Geriatr Soc. 2012 Dec;60(12):2297-301. doi: 10.1111/j.1532-5415.2012.04239.x. Epub 2012 Oct 30.
To identify the determinants of antihypertensive medication adherence in community-living elderly adults.
Longitudinal observational study.
Population-based health survey in the province of Quebec, Canada.
Data from a representative sample (N = 2,811) of community-dwelling adults in Quebec aged 65 and older participating in the Étude sur la Santé des Aînés study. The final study sample analyzed consisted of 926 participants taking antihypertensive drugs during the 2 years of the study.
Adherence to antihypertensive medication was measured using days of supply obtained during a specified time period. Depression and anxiety disorders were assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and physical health status was measured using the Charlson Comorbidity Index. Other factors considered were age, education, marital status, annual family income, and number of antihypertensive drugs that participants used.
Mean antihypertensive proportion (percentage) of days supplied in was 92.5% in Year 1 and 59.4% in Year 2. The presence of depression and anxiety disorders and the number of antihypertensive medications significantly predicted medication adherence. The sex by depression and anxiety disorders interaction term was significant.
Adherence to antihypertensive medication was significantly associated with depression and anxiety disorders in men but not women. The treatment of depression and anxiety disorders in individuals with hypertension may be helpful in improving medication adherence rates and healthcare outcomes.
确定社区居住的老年高血压患者药物治疗依从性的决定因素。
纵向观察性研究。
加拿大魁北克省基于人群的健康调查。
来自魁北克省年龄在 65 岁及以上的社区居住成年人的代表性样本（N=2811）的数据，他们参加了老年健康研究。最终分析的研究样本包括在研究的 2 年内服用抗高血压药物的 926 名参与者。
使用特定时间段内获得的供应天数来衡量抗高血压药物的依从性。使用《精神障碍诊断与统计手册》第四版标准评估抑郁和焦虑障碍，使用 Charlson 合并症指数测量身体健康状况。还考虑了其他因素，包括年龄、教育程度、婚姻状况、家庭年收入以及参与者使用的降压药物数量。
第 1 年和第 2 年的平均抗高血压药物供应天数比例（%）分别为 92.5%和 59.4%。抑郁和焦虑障碍的存在以及使用的降压药物数量显著预测了药物依从性。性别与抑郁和焦虑障碍的交互作用项具有统计学意义。
抗高血压药物的依从性与男性的抑郁和焦虑障碍显著相关，但与女性无关。在高血压患者中治疗抑郁和焦虑障碍可能有助于提高药物依从率和改善医疗保健结果。
