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老年患者的健康行为与药物依从性

Health Behaviors and Medication Adherence in Elderly Patients.

作者信息

Han Euna, Sohn Hyun Soon, Lee Ju-Yeun, Jang Sunme

机构信息

1 Euna Han, PhD, is with the College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Yeonsu-Gu, Incheon, South Korea.

2 Hyun Soon Sohn, PhD, is with the Graduate School of Clinical Pharmacy, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.

出版信息

Am J Health Promot. 2017 Jul;31(4):278-286. doi: 10.4278/ajhp.150205-QUAN-709. Epub 2016 Jan 5.

Abstract

PURPOSE

To explore the relationships of selected health behaviors to medication adherence.

DESIGN

A retrospective cohort study.

SETTING

Data from Korean national health insurance claims between January 2010 and June 2011.

SUBJECTS

Patients aged 65 years and older with hypertension (N = 662,170), hyperlipidemia (N = 244,702), or diabetes (N = 179,285).

MEASURES

Medication adherence as a medication possession ratio from January to June 2011 as a dependent variable. The waist circumference (cm) and the body mass index (weight in kilogram divided by height in meter squared) as a marker for obesity. Smoking, drinking, and physical activity as main independent variables.

ANALYSIS

A multivariate logistic regression.

RESULTS

Nonobese patients, as based on the waist circumference, were more likely to adhere to their medication (by 8.9% for hypertension, 6.2% for diabetes, and 3.5% for hyperlipidemia). Current smokers were less likely to adhere to their medication (by 8.7% for hypertension and 6.8% for diabetes), and moderate and heavy drinkers were also less likely to show medication adherence for diabetes (by 12.9% and 6.4%). Mild physical activity was related to a 1.1% to 1.8% increase in the likelihood of medication adherence across the three disease groups.

CONCLUSION

Health promotion programs for self-care health behaviors of elderly patients should emphasize good medication adherence to achieve successful self-management of diseases.

摘要

目的

探讨特定健康行为与药物依从性之间的关系。

设计

一项回顾性队列研究。

背景

数据来自2010年1月至2011年6月期间的韩国国民健康保险理赔记录。

研究对象

65岁及以上患有高血压(N = 662,170)、高脂血症(N = 244,702)或糖尿病(N = 179,285)的患者。

测量指标

将2011年1月至6月的药物持有率作为药物依从性的因变量。腰围(厘米)和体重指数(体重千克数除以身高米数的平方)作为肥胖的指标。吸烟、饮酒和身体活动作为主要自变量。

分析方法

多因素逻辑回归分析。

结果

以腰围为依据,非肥胖患者更有可能坚持服药(高血压患者为8.9%,糖尿病患者为6.2%,高脂血症患者为3.5%)。当前吸烟者坚持服药的可能性较小(高血压患者为8.7%,糖尿病患者为6.8%),中度和重度饮酒者在糖尿病患者中坚持服药的可能性也较小(分别为12.9%和6.4%)。轻度身体活动与三个疾病组药物依从性可能性增加1.1%至1.8%有关。

结论

针对老年患者自我保健健康行为的健康促进项目应强调良好的药物依从性,以实现疾病的成功自我管理。

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