Yue Zhao, Bin Wang, Weilin Qi, Aifang Yang
Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.
J Eval Clin Pract. 2015 Feb;21(1):166-72. doi: 10.1111/jep.12268. Epub 2014 Oct 16.
RATIONALE, AIMS AND OBJECTIVES: We aim to investigate a range of risk factors associated with medication adherence among Chinese hypertensive patients. We also aim to investigate the association between medication adherence and blood pressure control.
A cross-sectional study was conducted among Chinese hypertensive patients in a comprehensive teaching hospital in Shanghai, China, using a validated scale, a self-designed questionnaire and patients' medical records.
Of the 232 eligible participants, 61 (26.3%), 51 (22.0%) and 120 (51.7%) showed low, medium and high adherence, respectively. Adjusted for socio-demographic, clinical and patient-related factors, antihypertensive medication adherence was significantly associated with better systolic blood pressure control (P=0.001), whereas the association with diastolic blood pressure control was relatively weak (P=0.334). In the multivariate analysis, patients with longer duration of drug use [P=0.012, odds ratio (OR)=0.46, 95% confidence interval (CI) 0.25-0.84], combination of antiplatelet agents (0.002, 0.38, 0.20-0.71), less concerns of medical cost (0.001, 0.18, 0.02-0.51), more availability of professional guidance (0.002, 0.34, 0.17-0.66) and more availability of family support (0.036, 0.51, 0.27-0.96) were more likely to adhere to their drug regimens.
The rate of suboptimal medication adherence among Chinese hypertensive patients is quite high. Interventions could focus upon the risk factors to improve antihypertensive medication adherence in clinical practice.
原理、目的和目标：我们旨在调查一系列与中国高血压患者药物依从性相关的风险因素。我们还旨在研究药物依从性与血压控制之间的关联。
在中国上海一家综合性教学医院的中国高血压患者中进行了一项横断面研究，使用了经过验证的量表、自行设计的问卷和患者的病历。
在232名符合条件的参与者中，分别有61名（26.3%）、51名（22.0%）和120名（51.7%）表现出低、中、高依从性。在对社会人口统计学、临床和患者相关因素进行调整后，抗高血压药物依从性与更好的收缩压控制显著相关（P=0.001），而与舒张压控制的关联相对较弱（P=0.334）。在多变量分析中，用药时间较长的患者[P=0.012，比值比（OR）=0.46，95%置信区间（CI）0.25 - 0.84]、联合使用抗血小板药物（0.002，0.38，0.20 - 0.71）、对医疗费用担忧较少（0.001，0.18，0.02 - 0.51）、有更多专业指导（0.002，0.34，0.17 - 0.66）以及有更多家庭支持（0.036，0.51，0.27 - 0.96）的患者更有可能坚持其药物治疗方案。
中国高血压患者中药物依从性欠佳的比例相当高。在临床实践中，干预措施可聚焦于这些风险因素以提高抗高血压药物依从性。
