Malik Amonov, Yoshida Yoshitoku, Erkin Toirov, Salim Davlatov, Hamajima Nobuyuki
Department of Healthcare Administration, Nagoya University Graduate School of Medicine.
Department of General Practitioner, Samarkand State Medical Institute, Samarkand, Uzbekistan.
Nagoya J Med Sci. 2014 Aug;76(3-4):255-63.
Hypertension is one of the most important preventable causes of premature morbidity and mortality in the world. Many people with hypertension both in developing and developed countries have no adequate control of their blood pressure (BP). Hypertension-related knowledge and practice of patients play an important role in controlling hypertension and in preventing its long-term complications. The objective here was to study hypertension-related knowledge, practice and drug adherence of inpatients, and to examine an association between the knowledge regarding hypertension with BP control status and drug adherence. We studied hypertension-related knowledge, practice and drug adherence of patients in a hospital setting. A cross-sectional study was conducted among 209 patients with the diagnosis of primary hypertension at the Samarkand State Medical Institute. The study was conducted from June to September 2012. Drug adherence was studied using the Morisky 4-item self-report measure of medication-taking behavior. The reasons for drug non-adherence were assessed using a self-administered questionnaire. Odds ratio (OR) and 95% confidence interval (CI) were estimated by a logistic model. The BP control rate and drug adherence of the patients were suboptimal (24.4% and 36.8%, respectively). Overall, 64.6% of patients had good or adequate and 35.5% had inadequate knowledge about hypertension. Good knowledge of patients was significantly associated with controlled BP (OR=5.4, 95% CI, 1.7-16.2) and drug adherence (OR=3.8, 95% CI, 1.4-10.8). In conclusion, the inpatients of the secondary hospital had sufficient general knowledge about hypertension, but they had inadequate knowledge about specific issues such as treatment for and symptoms of hypertension. Both drug adherence and BP control rate were suboptimal and significantly associated with hypertension knowledge. This study specifies potential areas of hypertension education that could be improved by patients' knowledge of hypertension.
高血压是全球最重要的可预防的过早发病和死亡原因之一。在发展中国家和发达国家,许多高血压患者的血压都未得到充分控制。患者对高血压的相关知识和实践在控制高血压及预防其长期并发症方面发挥着重要作用。本研究的目的是探讨住院患者对高血压的相关知识、实践及药物依从性,并检验高血压知识与血压控制状况及药物依从性之间的关联。我们在医院环境中研究了患者对高血压的相关知识、实践及药物依从性。在撒马尔罕国立医学院对209例原发性高血压患者进行了一项横断面研究。研究于2012年6月至9月进行。使用Morisky 4项自我报告服药行为量表来研究药物依从性。通过自行填写的问卷评估药物不依从的原因。采用逻辑模型估计比值比(OR)和95%置信区间(CI)。患者的血压控制率和药物依从性都不理想(分别为24.4%和36.8%)。总体而言,64.6%的患者对高血压有良好或充分的了解,35.5%的患者了解不足。患者的良好知识水平与血压得到控制(OR = 5.4,95% CI,1.7 - 16.2)及药物依从性(OR = 3.8,95% CI,1.4 - 10.8)显著相关。总之,二级医院的住院患者对高血压有足够的一般知识,但对高血压的治疗和症状等具体问题了解不足。药物依从性和血压控制率都不理想,且与高血压知识显著相关。本研究明确了高血压教育的潜在改进领域,这些领域可通过患者对高血压的了解来改善。