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评估农村、城市和郊区人群药物依从性的影响因素。

Evaluating Factors Impacting Medication Adherence Among Rural, Urban, and Suburban Populations.

机构信息

Mathematics and Computer Science, Schmid College of Science and Technology, Chapman University, Orange, California.

Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California.

出版信息

J Rural Health. 2018 Sep;34(4):339-346. doi: 10.1111/jrh.12291. Epub 2018 Jan 10.

Abstract

PURPOSE

To evaluate differences in prescription medication adherence rates, as well as influencing factors, in rural and urban adults.

METHODS

This is a retrospective analysis of the 2015 National Consumer Survey on the Medication Experience and Pharmacists' Role. A total of 26,173 participants completed the survey and provided usable data. Participants using between 1 and 30 prescription medications and living more than 0 miles and up to 200 miles from their nearest pharmacy were selected for the study, resulting in a total of 15,933 participants. Data from the 2010 US Census and Rural Health Research Center were used to determine the population density of each participant's ZIP code. Participant adherence to reported chronic medications was measured based on the 8-item Morisky Medication Adherence Scale (MMAS-8).

FINDINGS

Overall adherence rates did not differ significantly between rural and urban adults with average adherence based on MMAS-8 scores of 5.58 and 5.64, respectively (P = .253). Age, income, education, male sex, and white race/ethnicity were associated with higher adherence rates. While the overall adherence rates between urban and rural adults were not significantly different, the factors that influenced adherence varied between age-specific population density groupings.

CONCLUSION

These analyses suggest that there is no significant difference in adherence between rural and urban populations; however, the factors contributing to medication adherence may vary based on age and population density. Future adherence intervention methods should be designed with consideration for these individualized factors.

摘要

目的

评估农村和城市成年人在处方药物依从率方面的差异,以及影响这些差异的因素。

方法

这是对 2015 年全国药物使用经验和药剂师角色消费者调查的回顾性分析。共有 26173 名参与者完成了调查并提供了可用数据。选择了使用 1 至 30 种处方药且距离最近的药店超过 0 英里但不超过 200 英里的参与者进行研究,最终共有 15933 名参与者。使用 2010 年美国人口普查和农村卫生研究中心的数据来确定每个参与者邮政编码的人口密度。根据 Morisky 药物依从性量表(MMAS-8)的 8 项内容来衡量报告的慢性药物的参与者的依从性。

发现

基于 MMAS-8 评分,农村和城市成年人的总体依从率没有显著差异,分别为 5.58 和 5.64(P =.253)。年龄、收入、教育程度、男性和白种人种族与更高的依从率相关。尽管城市和农村成年人的总体依从率没有显著差异,但影响依从性的因素因年龄和人口密度的特定分组而异。

结论

这些分析表明,农村和城市人群之间的依从率没有显著差异;然而,影响药物依从性的因素可能因年龄和人口密度而异。未来的依从性干预方法应考虑这些个体化因素进行设计。

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