尼日利亚西南部门诊护理环境中高血压和2型糖尿病患者的社会支持、治疗依从性及结果
Social Support, Treatment Adherence and Outcome among Hypertensive and Type 2 Diabetes Patients in Ambulatory Care Settings in southwestern Nigeria.
作者信息
Adisa Rasaq, Olajide Olamide O, Fakeye Titilayo O
机构信息
Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
出版信息
Ghana Med J. 2017 Jun;51(2):64-77.
OBJECTIVES
To evaluate available and desired sources and types of social-support among hypertensive and type-2-diabetes (T2D) patients. Associations of medication adherence and clinical outcome with access to most available social-support and medicine affordability were subsequently investigated.
DESIGN
Cross-sectional questionnaire-guided interview among 250-hypertensive and 200-T2D patients, and review of medical records to retrieve disease-specific clinical parameters.
SETTINGS
University College Hospital and Ring-Road State Hospital, Ibadan, southwestern Nigeria.
PARTICIPANTS
Adults out-patients with hypertension, T2D, and T2D comorbid with hypertension were enrolled, while in-patients were excluded.
RESULTS
Family source of support was the most available [hypertensive (225; 90.0%); T2D (174; 87.0%)], but government and non-governmental organisation support were largely desired, with financial support preferred, 233(93.2%) hypertensive and 190(95.0%) T2D, respectively. Adherent hypertensive patients with or without access to family support were (127; 56.4%) versus (18; 72.0%), p=0.135; while for T2D were (103; 59.2%) versus (21; 80.8%), p=0.035. Mean systolic blood pressure of hypertensive and fasting plasma glucose of T2D with access to family and financial support were better than their counterparts without access (p>0.05). Hypertensive (110; 76.4%) and T2D (87; 87.0%) participants who consistently afford medicine expenses had significantly better adherence and outcome (p<0.05).
CONCLUSIONS
Family source of support is the most accessible, but government and non-governmental organisation support were largely desired. Access to family support did not positively influence medication adherence, while access to financial support marginally impacted on outcome among hypertensive and T2D patients. However, unwavering tendency for therapy affordability significantly influenced adherence and outcome, thus, the need for expanded social-support system in order to consistently ensure improved outcome.
FUNDING
None declared.
目的
评估高血压患者和2型糖尿病（T2D）患者可获得的和期望的社会支持来源及类型。随后调查药物依从性和临床结局与获得最常见社会支持及药物可负担性之间的关联。
设计
对250名高血压患者和200名T2D患者进行横断面问卷调查引导的访谈，并查阅病历以获取特定疾病的临床参数。
地点
尼日利亚西南部伊巴丹的大学学院医院和环城州立医院。
参与者
纳入患有高血压、T2D以及T2D合并高血压的成年门诊患者，排除住院患者。
结果
家庭支持来源最为常见[高血压患者（225人；90.0%）；T2D患者（174人；87.0%）]，但政府和非政府组织的支持在很大程度上是患者所期望的，其中资金支持更受青睐，高血压患者中有233人（93.2%），T2D患者中有190人（95.0%）。有或没有家庭支持的高血压依从性患者分别为（127人；56.4%）和（18人；72.0%），p = 0.135；而T2D患者分别为（103人；59.2%）和（21人；80.8%），p = 0.035。获得家庭和资金支持的高血压患者的平均收缩压以及T2D患者的空腹血糖水平优于未获得支持的患者（p>0.05）。能够持续负担药费的高血压患者（110人；76.4%）和T2D患者（87人；87.0%）的依从性和结局显著更好（p<0.05）。
结论
家庭支持来源是最容易获得的，但政府和非政府组织的支持在很大程度上是患者所期望的。获得家庭支持并未对药物依从性产生积极影响，而获得资金支持对高血压和T2D患者的结局有轻微影响。然而，治疗可负担性的稳定趋势显著影响了依从性和结局，因此，需要扩大社会支持系统以持续确保改善结局。
资金
未声明。
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