Lewis Lisa M, Ogedegbe Chinwe, Ogedegbe Gbenga
School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA.
Expert Rev Cardiovasc Ther. 2012 Nov;10(11):1375-80. doi: 10.1586/erc.12.138.
Patient adherence to antihypertensive medication is an important strategy for blood pressure control in hypertensive patients. However, rates of antihypertensive medication adherence among hypertensive African-Americans are unacceptably low. This article examines the current understanding of patient, clinical, provider and healthcare system factors associated with medication adherence in hypertensive African-Americans. Studies demonstrated that patient and clinical factors, such as self-efficacy and depression, are consistently associated with medication adherence in hypertensive African-Americans patients. Provider communication shows promise as a correlate of medication adherence, but more research on provider and healthcare system factors are still needed. The authors recommend that interventions targeted at increasing medication adherence among hypertensive African-Americans focus on self-efficacy. It is also imperative that clinicians screen hypertensive patients for depression and treat, if necessary.
患者坚持服用抗高血压药物是高血压患者控制血压的一项重要策略。然而，非洲裔美国高血压患者的抗高血压药物依从率低得令人无法接受。本文探讨了目前对与非洲裔美国高血压患者药物依从性相关的患者、临床、医护人员及医疗保健系统因素的理解。研究表明，患者和临床因素，如自我效能感和抑郁，始终与非洲裔美国高血压患者的药物依从性相关。医护人员的沟通有望成为药物依从性的一个相关因素，但仍需要对医护人员及医疗保健系统因素进行更多研究。作者建议，针对提高非洲裔美国高血压患者药物依从性的干预措施应侧重于自我效能感。临床医生还必须对高血压患者进行抑郁症筛查，必要时进行治疗。
