Gillum R F, Neutra R R, Stason W B, Solomon H S
J Community Health. 1979 Winter;5(2):94-100. doi: 10.1007/BF01324011.
Noncompliance with follow-up is a serious problem in the management of hypertension. A retrospective cohort study examined dropout rates and their determinants among 249 randomly selected outpatients with essential hypertension from the medical clinic of an urban teaching hospital. Data were abstracted from hospital records and a subset of dropouts was interviewed. A lifetable analysis revealed that patients who were initiating therapy or who had been under therapy for less than six months had a 50% chance of remaining in care two years later, while 70% of patients who had been under therapy for more than six months at entry were still in care after this period. Patients who were less severely ill by several indicators were the most likely to drop out. It is hypothesized that the low perceived severity of illness, coupled with the costs and inconvenience of care and the lack of physician enthusiasm for the treatment of mild hypertension leads to non-compliance with follow-up.
不遵守随访在高血压管理中是一个严重问题。一项回顾性队列研究调查了一家城市教学医院门诊随机选取的249例原发性高血压门诊患者的失访率及其决定因素。数据从医院记录中提取，并对一部分失访患者进行了访谈。寿命表分析显示，开始治疗或治疗时间少于6个月的患者，两年后仍接受治疗的几率为50%，而入院时接受治疗超过6个月的患者，在此期间后仍有70%接受治疗。根据几项指标病情较轻的患者最有可能失访。据推测，对疾病严重程度的低认知度，加上护理的成本和不便，以及医生对轻度高血压治疗缺乏热情，导致不遵守随访。
