Teshome Destaw Fetene, Bekele Kindie Bantie, Habitu Yohannes Ayanaw, Gelagay Abebaw Addis
Department of Epidemiology and Biostatistics.
Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Integr Blood Press Control. 2017 Jun 16;10:1-7. doi: 10.2147/IBPC.S128914. eCollection 2017.
Medication adherence is an important predictor of optimal blood pressure control; hence, it significantly reduces the risk of cardiovascular disease (CVD) and associated deaths. However, studies on medication adherence and its associated factors are scarce. Thus, this study aimed to assess adherence to antihypertensive medications and identify associated factors at Debre Tabor General Hospital, northwest Ethiopia.
A hospital-based cross-sectional study was conducted. Simple random sampling technique was used to select 346 participants. A structured questionnaire adapted from the World Health Organization (WHO) STEPwise approach was used to collect data. Medication adherence was measured by the four-item Morisky-Green-Levine Scale, with a score ≥3 defined as "good adherence". Data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive and summary statistics were used. Bivariate and multivariable analyses were also carried out.
A total of 337 hypertensive patients participated in the study. Three-quarters (75.1%) of the participants were found to be adherent to their medication therapy. The multivariable logistic regression analysis showed that urban residence (adjusted odd ratio [AOR]=2.10, 95% confidence interval [CI]: 1.15, 3.85), taking less than two drugs per day (AOR=3.04, 95% CI: 1.53, 6.06), and having knowledge about hypertension (HTN) and its treatment (AOR=8.86, 95% CI: 4.67, 16.82) were positively and significantly associated with medication adherence, while age >60 years (AOR=0.33, 95% CI: 0.11, 0.98) was negatively and significantly associated with good medication adherence.
A significant proportion of hypertensive patients poorly adhere to antihypertensive medications. Age, residence, pill burden, and knowledge about HTN and its treatment are important predictors of medication adherence. Attention should be given to increase the knowledge of patients about their disease and its treatment, and due emphasis should also be given to older and rural patients.
药物依从性是血压得到最佳控制的重要预测指标；因此，它能显著降低心血管疾病（CVD）风险及相关死亡风险。然而，关于药物依从性及其相关因素的研究较少。因此，本研究旨在评估埃塞俄比亚西北部德布雷塔博尔综合医院患者的降压药依从性并确定相关因素。
开展了一项基于医院的横断面研究。采用简单随机抽样技术选取346名参与者。使用从世界卫生组织（WHO）逐步调查方法改编而来的结构化问卷收集数据。采用四项Morisky - Green - Levine量表测量药物依从性，得分≥3定义为“依从性良好”。数据使用Epi Info 7版录入，并导出至SPSS 20版进行分析。使用描述性和汇总统计方法。还进行了双变量和多变量分析。
共有337名高血压患者参与了本研究。四分之三（75.1%）的参与者被发现坚持药物治疗。多变量逻辑回归分析显示，城市居住（调整后比值比[AOR]=2.10，95%置信区间[CI]：1.15，3.85）、每天服用药物少于两种（AOR=3.04，95% CI：1.53，6.06）以及了解高血压（HTN）及其治疗方法（AOR=8.86，95% CI：4.67，16.82）与药物依从性呈正相关且具有显著相关性，而年龄>60岁（AOR=0.33，95% CI：0.11，0.98）与良好的药物依从性呈负相关且具有显著相关性。
相当一部分高血压患者对降压药的依从性较差。年龄、居住地点、服药负担以及对高血压及其治疗方法的了解是药物依从性的重要预测因素。应关注提高患者对自身疾病及其治疗方法的认识，同时也应特别关注老年患者和农村患者。
