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患者对长期药物治疗的依从性:奥地利抗高血压治疗方案的横断面研究

Adherence of patients to long-term medication: a cross-sectional study of antihypertensive regimens in Austria.

作者信息

Lötsch Felix, Auer-Hackenberg Lorenz, Groger Mirjam, Rehman Khalid, Morrison Valerie, Holmes Emily, Parveen Sahdia, Plumpton Catrin, Clyne Wendy, de Geest Sabina, Dobbels Fabienne, Vrijens Bernard, Kardas Przemyslaw, Hughes Dyfrig, Ramharter Michael

机构信息

Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

出版信息

Wien Klin Wochenschr. 2015 May;127(9-10):379-84. doi: 10.1007/s00508-015-0782-y. Epub 2015 Apr 24.

Abstract

OBJECTIVE

The objective of this study was to evaluate adherence and causes for non-adherence to antihypertensive therapy in Austrian patients. A special focus was placed on social parameters and behavioural theories.

METHODS

Patients were invited via advertisements in community pharmacies in Austria to complete an online survey. Inclusion criteria were an age of 18 years or older, a diagnosis of arterial hypertension and a current prescription of antihypertensive medication. Adherence was measured by the four-item Morisky scale. Non-adherence was defined by at least one point in the Morisky scale. Several demographic, social and behavioural parameters were analysed as potential co-variables associated with adherence.

RESULTS

A total of 323 patients completed the online survey, of which 109 (33.7%) met the criteria for non-adherence. In a multivariable model, self-efficacy and age were associated with adherence, whereas intention and barriers were linked to non-adherence; 56 patients (17.3%) were classified as intentionally non-adherent.

CONCLUSION

This study demonstrates that non-adherence affects an important proportion of patients in the treatment of arterial hypertension. Young age was a particularly important risk factor for non-adherence, and this patient population is, therefore, in need of special attention. Modifiable risk factors were identified that could help improving the treatment of arterial hypertension and potentially other chronic conditions.

摘要

目的

本研究的目的是评估奥地利患者对抗高血压治疗的依从性及不依从的原因。特别关注社会参数和行为理论。

方法

通过在奥地利社区药房张贴广告邀请患者完成一项在线调查。纳入标准为年龄在18岁及以上、诊断为动脉高血压且目前正在服用抗高血压药物。依从性通过四项Morisky量表进行测量。不依从定义为Morisky量表中至少得一分。分析了几个人口统计学、社会和行为参数作为与依从性相关的潜在协变量。

结果

共有323名患者完成了在线调查,其中109名(33.7%)符合不依从标准。在多变量模型中,自我效能感和年龄与依从性相关,而意图和障碍与不依从相关;56名患者(17.3%)被归类为故意不依从。

结论

本研究表明,不依从影响动脉高血压治疗中相当一部分患者。年轻是不依从的一个特别重要的危险因素,因此,这一患者群体需要特别关注。确定了可改变的危险因素,有助于改善动脉高血压及可能其他慢性病的治疗。

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