影响科威特高胆固醇血症患者他汀类药物依从性的因素：一项横断面研究。
Factors Affecting Adherence to Statins in Hypercholesterolemic Kuwaiti Patients: A Cross-Sectional Study.
作者信息
Al-Foraih Meisa, Somerset Shawn
机构信息
Public Authority for Applied Education and Training, Safat, Kuwait.
出版信息
Med Princ Pract. 2017;26(1):35-40. doi: 10.1159/000450644. Epub 2016 Sep 7.
OBJECTIVE
This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD).
SUBJECTS AND METHODS
Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to <8 denoting medium adherence and <6 denoting low adherence). Data regarding anthropometric, psychological and serum risk factors were collected using 2 additional questionnaires, laboratory tests and bioelectrical impedance scales. Binary logistic regression was used to determine predictors of adherence and general linear modelling was used to test relationships between continuous outcomes and statin adherence.
RESULTS
Of the 200 participants, 117 (58.5%) reported low adherence, 83 (41.5%) reported medium adherence and no patients (0%) scored high adherence. Younger patients (aged 30-50 years) had lower adherence than older patients (>50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01).
CONCLUSION
In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile.
目的
本研究调查了科威特高胆固醇血症患者的他汀类药物依从性，以确定与依从性差相关的因素，并确定他汀类药物依从性与冠心病（CHD）风险状况之间是否存在关联。
对象与方法
从科威特基层医疗诊所招募了200名高胆固醇血症患者（年龄在30 - 69岁之间），并就其人口统计学特征、既往自我报告的医疗状况和处方药物进行了访谈。使用Morisky药物依从性量表评估他汀类药物依从性（一份自我报告的药物依从性问卷，分为3个等级，得分8表示高依从性，6至<8表示中等依从性，<6表示低依从性）。使用另外两份问卷、实验室检查和生物电阻抗量表收集有关人体测量、心理和血清风险因素的数据。采用二元逻辑回归确定依从性的预测因素，并采用一般线性模型检验连续结果与他汀类药物依从性之间的关系。
结果
在200名参与者中，117名（58.5%）报告低依从性，83名（41.5%）报告中等依从性，没有患者（0%）得分高依从性。每增加一岁，年轻患者（30 - 50岁）的依从性低于老年患者（>50岁）[比值比（OR）1.05；95%置信区间（CI）1.01 - 1.09]；p < 0.01）。没有糖尿病的患者，即113名（56.5%），报告中等依从性的可能性低于患有糖尿病的患者（OR 0.42；95% CI 0.23 - 0.75；p < 0.01）。低他汀类药物依从性与较高的血浆胆固醇水平（p < 0.001）和低密度脂蛋白水平（p < 0.01）相关。
结论
在本研究中，他汀类药物低依从性的患病率较高，尤其是在合并疾病较少的年轻患者中。结果表明他汀类药物依从性与冠心病风险状况之间存在负相关关系。
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