南非农村地区基层医疗机构抗高血压治疗依从性及其影响因素评估。
Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa.
作者信息
Rampamba Enos M, Meyer Johanna C, Godman Brian, Kurdi Amanj, Helberg Elvera
机构信息
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa.
Department of Health, Tshilidzini Hospital, Limpopo Province, South Africa.
出版信息
J Comp Eff Res. 2018 Jul;7(7):661-672. doi: 10.2217/cer-2018-0004. Epub 2018 Jun 11.
AIM
To evaluate adherence to antihypertensive treatment in rural South Africa and identify potential determinants given concerns with adherence and its impact in this priority disease area. Patients & methods: Face-to-face interviews with hypertensive patients and rating their adherence to treatment using defined categorized responses. Associations between adherence and patient characteristics assessed and sensitivity analyses performed.
RESULTS
54.6% of patients were adherent to treatment. Controlled blood pressure (BP; odds ratios [OR] = 2.1; 95% CI: 1.1, 3.8; p = 0.019), comorbidity (OR = 2.0; 95% CI: 1.1, 3.6; p = 0.032) and smoking (OR = 0.3; 95% CI: 0.1, 0.8; p = 0.018) were associated with adherence.
CONCLUSION
Adherence and BP control were suboptimal, only smoking was an independent risk factor for adherence. Adherent patients were twice as likely to have controlled BP, although results were sensitive to the definition of adherence. Initiatives are in place to improve adherence, which will be monitored.
目的
鉴于高血压治疗依从性及其影响在这一重点疾病领域受到关注，评估南非农村地区高血压治疗的依从性，并确定潜在的决定因素。患者与方法：对高血压患者进行面对面访谈，并使用既定的分类回答对他们的治疗依从性进行评分。评估依从性与患者特征之间的关联，并进行敏感性分析。
结果
54.6%的患者坚持治疗。血压得到控制（血压；优势比[OR]=2.1；95%置信区间：1.1，3.8；p=0.019）、合并症（OR=2.0；95%置信区间：1.1，3.6；p=0.032）和吸烟（OR=0.3；95%置信区间：0.1，0.8；p=0.018）与依从性相关。
结论
依从性和血压控制不理想，只有吸烟是依从性的独立危险因素。坚持治疗的患者血压得到控制的可能性是其他患者的两倍，尽管结果对依从性的定义很敏感。目前正在采取措施提高依从性，并将对其进行监测。
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