Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University.
Makurazaki Municipal Hospital.
Circ J. 2018 Mar 23;82(4):1051-1061. doi: 10.1253/circj.CJ-17-1015. Epub 2018 Feb 15.
Patient-physician concordance is an important concern in the treatment of elderly patients with hypertension (HT). Treatment that considers concordance is necessary for mutual understanding and therapeutic satisfaction between patients and physicians. However, there have been no studies addressing concordance that objectively analyzed both patient and physician satisfaction before and after treatment.
An exploratory open-label, multicenter, intervention study was conducted. Patients with HT undergoing treatment with angiotensin-receptor blocker (ARB) or a calcium-channel blocker (CCB) monotherapy were enrolled. Medication was switched to an ARB/CCB combination tablet and taken for 12 weeks. Physicians and patients participated in satisfaction surveys concerning treatment. Discrepancies in satisfaction levels between patients and physicians were found at baseline for the following survey items: treatment, involvement in treatment, understanding of HT, reliance, medication, and blood pressure. After treatment, the satisfaction levels of both patients and physicians increased; discrepancies in satisfaction between the groups also improved.
The rates of satisfaction were relatively higher for patients compared with physicians at baseline. After HT treatment addressing concordance, both patient and physician satisfaction rates and the gap in satisfaction rates between patients and physicians improved. This indicates that addressing concordance has clinical significance in the treatment of elderly HT patients. (UMIN000017270).
在治疗老年高血压(HT)患者时,医患一致是一个重要关注点。考虑到一致性的治疗对于患者和医生之间的相互理解和治疗满意度是必要的。然而,目前还没有研究针对治疗前和治疗后客观分析医患双方满意度的一致性。
进行了一项探索性、开放性、多中心的干预研究。纳入正在接受血管紧张素受体阻滞剂(ARB)或钙通道阻滞剂(CCB)单药治疗的 HT 患者。将药物转换为 ARB/CCB 联合片剂,并服用 12 周。医生和患者参与了有关治疗的满意度调查。在基线时,以下调查项目的患者和医生的满意度存在差异:治疗、参与治疗、对 HT 的理解、依赖、药物和血压。治疗后,患者和医生的满意度均有所提高;两组之间的满意度差异也有所改善。
在基线时,患者的满意度相对高于医生。在针对一致性的 HT 治疗后,患者和医生的满意度以及患者和医生满意度之间的差距均有所提高。这表明,在治疗老年 HT 患者时,解决一致性具有临床意义。(UMIN000017270)。