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自我报告的药物治疗依从性得分与收缩压控制之间的关联:一项收缩压干预试验(SPRINT)基线数据研究

The association between Self-Reported Medication Adherence scores and systolic blood pressure control: a SPRINT baseline data study.

作者信息

Haley William E, Gilbert Olivia N, Riley Robert F, Newman Jill C, Roumie Christianne L, Whittle Jeffrey, Kronish Ian M, Tamariz Leonardo, Wiggers Alan, Morisky Donald E, Conroy Molly B, Kovalik Eugene, Kressin Nancy R, Muntner Paul, Goff David C

机构信息

Mayo Clinic, Jacksonville, FL, USA.

Section on Cardiovascular Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA.

出版信息

J Am Soc Hypertens. 2016 Nov;10(11):857-864.e2. doi: 10.1016/j.jash.2016.08.009. Epub 2016 Sep 7.

Abstract

We examined baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT) to investigate whether medication adherence, measured by the 8-item Morisky Medication Adherence Scale (MMAS-8), was associated with systolic blood pressure (SBP) and whether MMAS-8 score and number of antihypertensive medications interacted in influencing SBP. A total of 8435 SPRINT participants were included: 21.2% had low adherence (MMAS-8: <6); 40.0% had medium adherence (6 to <8); and 38.8% had high adherence (8). SBP was <140 mm Hg in 54.6%; 140-160 mm Hg in 36.6%; and >160 mm Hg in 8.8%. In multivariable regression, medium vs. low adherence weakly associated with lower SBP (odds ratio: 1.17; confidence interval: 1.04, 1.31). SPRINT eligibility criteria should be considered when interpreting results. Efforts to understand and enhance adherence are crucial to improve population health, and using self-report instruments might be considered for predicting treatment adherence and response in future efficacy trials and for identifying patients for adherence support in clinical practice.

摘要

我们分析了收缩压干预试验(SPRINT)的基线数据,以研究通过8项Morisky药物依从性量表(MMAS-8)测量的药物依从性是否与收缩压(SBP)相关,以及MMAS-8评分和抗高血压药物数量在影响SBP方面是否存在相互作用。共纳入了8435名SPRINT参与者:21.2%的人依从性低(MMAS-8:<6);40.0%的人依从性中等(6至<8);38.8%的人依从性高(8)。收缩压<140 mmHg的占54.6%;140 - 160 mmHg的占36.6%;>160 mmHg的占8.8%。在多变量回归分析中,中等依从性与低依从性相比,与较低的收缩压弱相关(比值比:1.17;置信区间:1.04,1.31)。解读结果时应考虑SPRINT的纳入标准。理解并提高依从性的努力对于改善人群健康至关重要,在未来的疗效试验中,可考虑使用自我报告工具来预测治疗依从性和反应,并在临床实践中识别需要依从性支持的患者。

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