Quinn Colin, Deegan Brian, Cooke John, Carew Sheila, Hannigan Ailish, Dunne Colum, Lyons Declan
Department of Medicine, Division of Ageing and Therapeutics, University Hospital Limerick, Ireland.
Department of Bioelectronic Engineering, National University of Ireland, Galway, Ireland.
Age Ageing. 2015 Mar;44(2):339-42. doi: 10.1093/ageing/afu162. Epub 2014 Oct 24.
Elastic compression stockings (ECS) can be used as a non-pharmacological therapeutic option for older patients with orthostatic hypotension (OH). We aimed to investigate the practices and views of patients and physicians regarding the use of ECS for OH.
Two surveys were designed. The first was sent to 90 patients known to have been prescribed ECS for OH. This questionnaire included items related to the frequency of use and issues related to non-compliance. The second was sent to 69 consultant physicians in geriatric medicine. This included items related to prescribing practices and perceived patient compliance.
Sixty-seven patients responded (response rate, 74%) and of those 64% were female. Mean age (SD) was 75.1 years (10.5), range 45-91 years. Thirty-three per cent wore ECS daily, whereas 43% never used them. Over half (51%) of the patients reported difficulty in application and 31% reported discomfort. Those aged 75 or older were more likely to report difficulty in application (P=0.003). Forty-eight physicians responded (response rate, 70%). Eighty-nine per cent prescribe ECS for OH. There were significant differences between the frequency of use reported by patients and predicted by physicians (P<0.001), with physicians less likely to predict daily or non-use. Eighty-nine per cent of physicians predicted that difficulty in application was the main reason for non-compliance.
Although prescribed frequently, the use of ECS in patients with OH is often limited by issues related to practicality. Physicians correctly predicted the main reasons for non-compliance although underestimated the scale of patient compliance with ECS.
弹力加压袜（ECS）可作为老年体位性低血压（OH）患者的一种非药物治疗选择。我们旨在调查患者和医生对于使用ECS治疗OH的做法和观点。
设计了两项调查问卷。第一项问卷发送给90名已知因OH而被开具ECS处方的患者。该问卷包括与使用频率以及不依从相关问题的项目。第二项问卷发送给69名老年医学顾问医生。其中包括与处方做法以及感知到的患者依从性相关的项目。
67名患者做出了回应（回应率为74%），其中64%为女性。平均年龄（标准差）为75.1岁（10.5），年龄范围为45 - 91岁。33%的患者每天穿着ECS，而43%的患者从未使用过。超过一半（51%）的患者表示穿戴困难，31%的患者表示有不适感。75岁及以上的患者更有可能报告穿戴困难（P = 0.003）。48名医生做出了回应（回应率为70%）。89%的医生为OH患者开具ECS。患者报告的使用频率与医生预测的频率之间存在显著差异（P < 0.001），医生不太可能预测到每日使用或不使用的情况。89%的医生预测穿戴困难是不依从的主要原因。
尽管ECS的处方开具频率较高，但在OH患者中其使用常常受到实用性相关问题的限制。医生正确预测了不依从的主要原因，尽管低估了患者对ECS的依从程度。
