印度南部泰米尔纳德邦坎契普尔姆区农村人口中患者对高血压药物依从性的决定因素
Determinants of Patient's Adherence to Hypertension Medications in a Rural Population of Kancheepuram District in Tamil Nadu, South India.
作者信息
Venkatachalam J, Abrahm Sherin Billy, Singh Zile, Stalin P, Sathya G R
机构信息
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India.
Department of Physiology, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India.
出版信息
Indian J Community Med. 2015 Jan-Mar;40(1):33-7. doi: 10.4103/0970-0218.149267.
CONTEXT
Non-communicable diseases, no longer a disease of the rich, impose a great threat in the developing nations due to demographic and epidemiological transition. This increasing burden of non-communicable diseases and their risk factors is worrisome. Adherence to hypertension (HT) medication is very important for improving the quality of life and preventing complications of HT.
AIM
To study the factors determining adherence to HT medication.
SETTINGS AND DESIGN
A community-based cross-sectional study was conducted in a rural area of Kancheepuram district, Tamil Nadu, with a total population of around 16,005.
MATERIALS AND METHODS
This study was carried out over a period of 6 months (February-July) using a pre-structured and validated questionnaire. All eligible participants were selected by house-to-house survey and individuals not available on three consecutive visits were excluded from the study. The questionnaire included information on demographic characteristics, lifestyle habits, adherence to HT medication, blood pressure, and body mass index (BMI). Caste was classified based on Tamil Nadu Public Service commission.
STATISTICAL ANALYSIS
Data were entered in MS Excel and analyzed in SPSS version 16. P value <0.05 was considered statistically significant. Ethical Consideration: Informed verbal consent was obtained prior to data collection. The patient's adherence to HT medication was assessed using the Morisky 4-Item Self-Report Measure of Medication-taking Behavior [MMAS-4].
RESULTS
We studied 473 hypertensive patients of which 226 were males and 247 were females. The prevalence of adherence was 24.1% (n = 114) in the study population. Respondents with regular physical activity, non-smokers and non-alcoholics were more adherent to HT medication as compared with respondents with sedentary lifestyle, smoking and alcohol intake (P < 0.005). Based on health belief model, the respondents who perceived high susceptibility, severity, benefit had better adherence compared with moderate and low susceptibility, severity, benefit.
背景
非传染性疾病不再是富人的专利，由于人口结构和流行病学转变，在发展中国家构成了巨大威胁。非传染性疾病及其危险因素的负担日益加重，令人担忧。坚持服用高血压药物对于改善生活质量和预防高血压并发症非常重要。
目的
研究决定高血压药物依从性的因素。
设置与设计
在泰米尔纳德邦坎契普尔姆区的一个农村地区进行了一项基于社区的横断面研究，总人口约为16,005人。
材料与方法
本研究使用预先构建并经过验证的问卷，历时6个月（2月至7月）。通过逐户调查选择所有符合条件的参与者，连续三次访视均未找到的个体被排除在研究之外。问卷包括人口统计学特征、生活方式习惯、高血压药物依从性、血压和体重指数（BMI）等信息。种姓根据泰米尔纳德邦公共服务委员会进行分类。
统计分析
数据录入MS Excel并在SPSS 16版中进行分析。P值<0.05被认为具有统计学意义。伦理考量：在数据收集之前获得了知情口头同意。使用Morisky药物服用行为4项自我报告量表[MMAS-4]评估患者对高血压药物的依从性。
结果
我们研究了473名高血压患者，其中男性226名，女性247名。研究人群中依从性患病率为24.1%（n = 114）。与久坐不动的生活方式、吸烟和饮酒的受访者相比，经常进行体育锻炼、不吸烟和不饮酒的受访者对高血压药物的依从性更高（P < 0.005）。根据健康信念模型，与中等和低易感性、严重性、益处相比，认为高易感性、严重性、益处的受访者依从性更好。
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