Girerd X, Hanon O, Pannier B, Vaïsse B
Comité français de lutte contre l'hypertension artérielle (CFLHTA), 5, rue des Colonnes-du-trône, 75012 Paris, France; Unité de prévention cardiovasculaire, pôle cœur métabolisme, hôpital de La Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
Comité français de lutte contre l'hypertension artérielle (CFLHTA), 5, rue des Colonnes-du-trône, 75012 Paris, France; EA 4468, hôpital Broca service de gériatrie, AP-HP, université Paris Descartes, 54-56, rue Pascal, 75013 Paris, France.
Ann Cardiol Angeiol (Paris). 2017 Jun;66(3):149-153. doi: 10.1016/j.ancard.2017.04.001. Epub 2017 May 26.
To investigate the determinants of non-compliance with antihypertensive treatments among participants in the FLAHS 2015 survey and to develop a risk calculator for drug compliance in a hypertensive population.
The FLAHS surveys are carried out by self-questionnaire sent by mail to individuals from the TNS SOFRES (representative panel of the population living in metropolitan France) sampling frame. In 2015, FLAHS was performed in subjects aged 55years and older. Using the Girerd questionnaire, the "perfect observance" was determined for a score of 0 and "nonobservance" for a score of 1 or higher. A Poisson regression was conducted in univariate and multivariate to estimate risk ratios for each determinant. A non-compliance risk calculator is constructed from multivariate analysis. A Poisson regression was performed in univariate and multivariate to estimate risk ratios. For each sex, a probability table is produced from the equation of the multivariate analysis and then the calculation of a nonobservance probability ratio (PR) using the profile with the best probability as a reference. Each subject is then classified into one of the three classes of risk of non-compliance: low (PR <1.5), high (PR>=2) and intermediate (PR>=1.5 and <2).
The survey included 6379 subjects and analysis based on 2370 treated hypertensives. The onset of treatment was less than 2years in 7% of subjects and the median follow-up duration of treatment was 10years. Perfect compliance was observed in 64% of subjects. Independent determinants of non-compliance are: male sex, young age, number of antihypertensive tablet, treatment for a metabolic disease (diabetes, dyslipidemia), presence of other chronic illness, secondary prevention of cardiovascular disease. To get the risk class of nonobservance a web page is available at http://www.comitehta.org/flahs-observance-hta/.
The development of the FLAHS Compliance Test is a tool whose use is possible during an office visit. Its free availability for French doctor will be one of the actions undertaken as part of the "call for action for adherence in hypertension" proposed by the French League Against Hypertension in 2017.
调查2015年法国健康与社会经济状况调查（FLAHS）参与者中抗高血压治疗不依从的决定因素，并为高血压人群开发药物依从性风险计算器。
FLAHS调查通过邮寄自填问卷的方式，对来自TNS SOFRES（法国本土居民代表性样本）抽样框架中的个体进行。2015年，FLAHS在55岁及以上的受试者中开展。使用吉尔德问卷，得分为0表示“完全依从”，得分1或更高表示“不依从”。进行单变量和多变量泊松回归，以估计每个决定因素的风险比。根据多变量分析构建不依从风险计算器。进行单变量和多变量泊松回归以估计风险比。对于每种性别，根据多变量分析方程生成概率表，然后以概率最佳的特征为参考计算不依从概率比（PR）。然后将每个受试者分为不依从风险的三个类别之一：低（PR<1.5）、高（PR>=2）和中（PR>=1.5且<2）。
该调查纳入6379名受试者，基于2370名接受治疗的高血压患者进行分析。7%的受试者治疗开始时间少于2年，治疗的中位随访时间为10年。64%的受试者表现为完全依从。不依从的独立决定因素包括：男性、年轻、抗高血压药片数量、代谢疾病（糖尿病、血脂异常）治疗、其他慢性病的存在、心血管疾病的二级预防。要获取不依从的风险类别，可访问网页http://www.comitehta.org/flahs-observance-hta/。
FLAHS依从性测试的开发是一种在门诊就诊时可用的工具。其对法国医生免费提供将是作为法国高血压联盟在2017年提出的“高血压依从性行动呼吁”一部分所采取的行动之一。
